泌尿系结石是常见泌尿系统疾病之一，2024年泌尿系结石诊治取得了重要进展，包括新一代基因组学研究揭示了更多与结石形成相关的遗传变异；人工智能、机器深度学习、大数据等技术在泌尿系结石诊治方面得到广泛应用，显著提高了临床诊治水平；新型一次性电子输尿管软镜、肾镜及配套智能控温控压技术使得结石微创手术更加安全有效；更多机器人辅助结石手术平台开展临床应用；药物预防结石复发取得新的成果。这些进展将有助于为患者提供个体化的管理方案，显著提高治疗效果，改善患者的生活质量。

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洪扬,许清泉.2024年泌尿系结石诊治进展[J].泌尿外科杂志(电子版),2025,17(1):3-10.DOI:10.20020/j.CNKI.1674-7410.2025.01.01

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泌尿系结石是全球常见的泌尿系统疾病，发病率逐年上升。我国上尿路结石患病率上升到8%左右，两广地区甚至超过10%^[1]。结石的形成与多种因素有关，包括遗传、饮食、脱水、肥胖以及代谢异常等。肾结石早期症状不明显，且治疗后易复发，长期管理难度大，尽管结石微创手术有了很大进步，但是复杂肾结石的治疗仍然棘手。近年来，伴随着泌尿系结石微创手术技术，尤其是输尿管软镜技术的进展，从事泌尿系结石手术的医生越来越多，而泌尿系结石，特别是肾结石的治疗方式也发生了显著变化。EMILY等^[2]分析了一项美国医保数据，发现2013-2021年，肾结石的微创治疗方法（体外冲击波碎石、输尿管镜碎石术及经皮肾镜碎石术）比例发生了显著变化。输尿管镜碎石术成为最受欢迎的手术方式，从2013年占比37%上升到2021年占比64%。体外冲击波碎石占比则从2013年62%降低到2021年34%。这期间从事输尿管镜碎石术和经皮肾镜碎石术的医生数量翻了一番以上。国内同行在泌尿系结石领域作出了较大贡献，ZYOUD等^[3]使用文献计量技术分析1979-2023年发表的泌尿结石相关随机对照试验资料，共有693篇随机对照研究文献，国内同行贡献最大，发表了166篇（23.95%），其次是美国，发表130篇文章（18.76%）。2024年，泌尿系结石在诊断、治疗及预防复发等方面取得了不少进展，人工智能、机器深度学习、大数据模型等技术在泌尿系结石诊治方面得到广泛应用，显著提高了临床诊治水平，提高了工作效率。本文将重点结合2024年发表的文献简要介绍泌尿系结石代谢评估、分子诊断、影像技术、微创手术、药物治疗以及预防方面的进展。

1 泌尿系结石诊断技术进展

1.1 代谢评估和分子诊断

1.2 影像技术

1.3 人工智能、机器深度学习、大数据模型等技术在泌尿系结石诊断方面的应用

2 结石治疗进展

2.1 碎石设备

2.2 辅助设备

2.3 结石微创手术

2.4 AI、机器深度学习、大数据模型等技术在泌尿系结石治疗方面的应用3.预防4.存在的问题5.小结和展望

未来研究需要进一步深入探索不同成分肾结石形成的机制，AI、机器学习及大数据技术，通过整合遗传学、代谢组学、生活方式等因素，医生将能够为高风险患者梳理详细的危险因素，并制定个体化的策略，避免结石的发生或复发。结石治疗措施，从草酸钙结石溶石药物到更加高效安全的碎石技术，也有望取得进展。

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