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远端输尿管结石的冲击波碎石术:仰卧位还是俯卧位。

Shock wave lithotripsy for distal ureteric stones: supine or prone.

作者信息

Istanbulluoglu Mustafa Okan, Hoscan Mustafa Burak, Tekin Mehmet Ilteris, Cicek Tufan, Ozturk Bulent, Ozkardes Hakan

机构信息

Department of Urology, Konya Education Hospital, Baskent University School of Medicine, 42060, Konya, Turkey.

出版信息

Urol Res. 2011 Jun;39(3):177-80. doi: 10.1007/s00240-010-0322-1. Epub 2010 Oct 21.

Abstract

Shock wave lithotripsy (SWL) has become the preferred first-line approach to most patients with symptomatic urolithiasis. The purpose of this study is to assess the ideal patient position during SWL for the treatment of distal ureter stones. A total of 342 patients included in this retrospective study. 148 (108 men, 40 women) patients were included in the first group and were treated in supine position. The remaining 194 (143 men, 51 women) patients were included to second group and were treated in prone position. This study designed retrospectively. The procedure was accepted as a success if the patient was stone free or had only clinically insignificant fragments (≤3 mm) for 3 months or more after the last SWL session. Before SWL, the mean is one area in the first group was 61.32 mm2 while the mean stone area in the second group was 59.04 mm2 (p = 0.208). Mean energy, Mean energy maximum and mean number of applied shock waves of the first group was 4.65, 3.19 and 3,960, respectively. The same parameters in second group were 4.26, 3.03 and 2,953, respectively. These results show that there are statistically significant differences between two groups with respect to mean energy, mean energy maximum and mean number of applied shock waves (p = 0.003, p = 0.010, p = 0.000, respectively). Success rate was 85.1% in group 1 and 72.7% in group 2 (p = 0.006). Our results suggest that supine position is effective and better than prone position for SWL in patients with distal ureteric stones.

摘要

冲击波碎石术(SWL)已成为大多数有症状尿路结石患者的首选一线治疗方法。本研究的目的是评估SWL治疗远端输尿管结石时的理想患者体位。本回顾性研究共纳入342例患者。第一组纳入148例患者(108例男性,40例女性),采用仰卧位治疗。其余194例患者(143例男性,51例女性)纳入第二组,采用俯卧位治疗。本研究为回顾性设计。如果患者在最后一次SWL治疗后3个月或更长时间内结石清除或仅有临床意义不大的碎片(≤3mm),则该治疗过程被视为成功。SWL治疗前,第一组结石平均面积为61.32mm²,而第二组结石平均面积为59.04mm²(p = 0.208)。第一组的平均能量、平均最大能量和平均冲击波应用次数分别为4.65、3.19和3960。第二组的相同参数分别为4.26、3.03和2953。这些结果表明,两组在平均能量、平均最大能量和平均冲击波应用次数方面存在统计学显著差异(分别为p = 0.003、p = 0.010、p = 0.000)。第一组成功率为85.1%,第二组为72.7%(p = 0.006)。我们的结果表明,对于远端输尿管结石患者,SWL治疗时仰卧位比俯卧位更有效且更好。

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