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[尿石症诊疗指南:诊断与治疗的更新]

[Guidelines on urolithiasis: update of diagnosis and treatment].

作者信息

Mugiya Soichi

机构信息

The Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan.

出版信息

Hinyokika Kiyo. 2012 Dec;58(12):703-6.

Abstract

The Japanese urolithiasis clinical guideline was established in 2002. Since that time, the American Urological Associstion (AUA) and European Association of Urology (EAU) nephrolithiasis guideline panel has developed several guidelines on the management of urolithiasis. Recently, the joint AUA/EAU panel published a 2007 update of the original 1997 report on the management of ureteral calculi. The EAU panel yields the publication of guidelines on urolithiasis, with updates almost annually. These guidelines provide useful recommendations on the management of urolithiasis. Based on their findings, the most significant update of guideline concluded that both extracorporeal shockwave lithotripsy and ureteroscopy (URS) are acceptable first-line treatments for patients requiring ureteral stone removal. With the development of smaller caliber ureteroscopes and the introduction of improved instrumentation, including the holmium : yttrium aluminum garnet laser, URS has evolved into a safer and more efficacious modality for treatment of stones in all locations in the ureter during the last decade. The other change is the establishment of effective medical expulsive therapy to facilitate spontaneous stone passage.

摘要

日本尿石症临床指南于2002年制定。自那时起,美国泌尿外科学会(AUA)和欧洲泌尿外科学会(EAU)尿石症指南小组就尿石症的管理制定了多项指南。最近,AUA/EAU联合小组发布了2007年对1997年输尿管结石管理原始报告的更新。EAU小组几乎每年都会发布尿石症指南的更新版本。这些指南为尿石症的管理提供了有用的建议。基于他们的研究结果,指南最重大的更新得出结论,体外冲击波碎石术和输尿管镜检查(URS)都是需要去除输尿管结石的患者可接受的一线治疗方法。随着更小口径输尿管镜的发展以及包括钬:钇铝石榴石激光在内的改进器械的引入,在过去十年中,URS已发展成为一种更安全、更有效的治疗输尿管各部位结石的方法。另一个变化是建立了有效的药物排石疗法以促进结石自然排出。

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