Xue Yuquan, Zhang Peng, Yang Xiaojie, Chong Tie
Department of Urology, The Second Affiliated Hospital of Xi'an Jiaoton University , Xi'an, China .
J Endourol. 2015 May;29(5):537-41. doi: 10.1089/end.2014.0778. Epub 2015 Jan 7.
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.
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).
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.
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.
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。
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)。
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。