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结石成分对逆行性肾内手术疗效的影响:直径1至3厘米的肾结石

The Effect of Stone Composition on the Efficacy of Retrograde Intrarenal Surgery: Kidney Stones 1 - 3 cm in Diameter.

作者信息

Xue Yuquan, Zhang Peng, Yang Xiaojie, Chong Tie

机构信息

Department of Urology, The Second Affiliated Hospital of Xi'an Jiaoton University , Xi'an, China .

出版信息

J Endourol. 2015 May;29(5):537-41. doi: 10.1089/end.2014.0778. Epub 2015 Jan 7.

Abstract

PURPOSE

The goal of this study was to analyze the effect of stone composition on the efficacy of retrograde intrarenal surgery (RIRS) with kidney stones of 1-3 cm, 1-2 cm, and 2-3 cm in diameter.

METHODS

We undertook a retrospective analysis of 74 patients with kidney stones who underwent RIRS. The patients were divided into two groups based on stone composition: Group I (n=47) (calcium oxalate monohydrate and calcium phosphate) was the hard to fragment stone group and group II (n=27) (calcium oxalate dihydrate, magnesium ammonium phosphate, and uric acid) was the easy to fragment stone group. Forty-six patients with kidney stones 1 to 2 cm in diameter were divided into group A (n=30) (smaller than 20 mm, hard to fragment stones) and group B (n=16) (smaller than 20 mm, easy to fragment stones). Twenty-eight patients with stones 2 to 3 cm in diameter were divided into group C (n=17) (larger than 20 mm, hard to fragment stones) and group D (n=11) (larger than 20 mm, easy-to-crush stones).

RESULTS

The stone clearance rates of group I and group II were 66.0% and 88.9%, respectively (P<0.05). The stone clearance rates of group A and group B were 73.3% and 100% (P<0.05). The stone clearance rates of group C and group D were 52.9% and 72.7%, respectively.

CONCLUSION

Stone composition has a significant impact on the efficacy of RIRS in the management of 1 to 3 cm kidney stones. For 2-3 cm calcium oxalate dihydrate stones, uric acid stones, and magnesium ammonium phosphate stones, the outcome of RIRS treatment was relatively good, and RIRS is recommended.

摘要

目的

本研究的目的是分析结石成分对直径为1 - 3厘米、1 - 2厘米和2 - 3厘米肾结石的逆行肾内手术(RIRS)疗效的影响。

方法

我们对74例行RIRS的肾结石患者进行了回顾性分析。根据结石成分将患者分为两组:第一组(n = 47)(一水合草酸钙和磷酸钙)为难以破碎结石组,第二组(n = 27)(二水合草酸钙、磷酸镁铵和尿酸)为易于破碎结石组。46例直径1至2厘米的肾结石患者分为A组(n = 30)(小于20毫米,难以破碎结石)和B组(n = 16)(小于20毫米,易于破碎结石)。28例直径2至3厘米的结石患者分为C组(n = 17)(大于20毫米,难以破碎结石)和D组(n = 11)(大于20毫米,易于破碎结石)。

结果

第一组和第二组的结石清除率分别为66.0%和88.9%(P < 0.05)。A组和B组的结石清除率分别为73.3%和100%(P < 0.05)。C组和D组的结石清除率分别为52.9%和72.7%。

结论

结石成分对1至3厘米肾结石的RIRS治疗效果有显著影响。对于2 - 3厘米的二水合草酸钙结石、尿酸结石和磷酸镁铵结石,RIRS治疗效果相对较好,推荐使用RIRS。

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