Tsvettsikh V E, Lerner G Ia, Kazeko N I, Red'kin V A, Sultanbaev V R, Molokov Iu M, Ovchinnikov A A, Sultanbaev R A, Lykov V N
Urol Nefrol (Mosk). 1990 May-Jun(3):9-12.
A total of 184 patients with dendritic nephrolithiasis (74.5% females and 25.5% males) were under study. It was established that in more than half of them the disease developed from the infectious inflammation of the urinary tract. Based on the findings, the authors supposed that in these patients the initial instability of cellular membranes was associated with a decrease in nonspecific resistance which was unfavourably complicated by infection of the urinary tracts and the formation of calcium phosphate calculus. As the presence of friable (low-contrast) calculi in the state of growth is accompanied by a severe inflammation, a continuous nonoperative treatment is mandatory. When the growth of the calculus is stopped and confirmed by its high-contrast dense X-ray shadow and the signs of inflammation ceased the authors insisted on the conduction of the 3-4-week inpatient preoperative management. The latter should include the administration of wide-range antibiotics, drugs for potentiation of nonspecific resistance and the complex of vitamins. Subcortical pyelolithotomy with partial nephrotomy is a method of choice in case of a "dry kidney". An average postoperative bedtime comprised 22.3 days.
共有184例树状肾结石患者(女性占74.5%,男性占25.5%)参与研究。结果表明,其中超过半数患者的疾病由泌尿系统感染性炎症发展而来。基于这些发现,作者推测在这些患者中,细胞膜的初始不稳定性与非特异性抵抗力下降有关,而泌尿系统感染和磷酸钙结石的形成又使情况恶化。由于生长状态下易碎(低对比度)结石的存在伴有严重炎症,持续的非手术治疗是必要的。当结石生长停止,并通过其高对比度致密X线阴影得到证实,且炎症迹象消失后,作者坚持进行为期3 - 4周的住院术前管理。后者应包括使用广谱抗生素、增强非特异性抵抗力的药物以及维生素复合物。对于“无积水肾”,皮质下肾盂切开取石术联合部分肾切除术是首选方法。术后平均卧床时间为22.3天。