体外物理振动排石促进逆行肾内手术后上尿路结石的清除：一项前瞻性、多中心、随机对照试验。
External Physical Vibration Lithecbole Promotes the Clearance of Upper Urinary Stones after Retrograde Intrarenal Surgery: A Prospective, Multicenter, Randomized Controlled Trial.
机构信息
Department of Urology, Minimally Invasive Surgery Center, First Affiliated Hospital of Guangzhou Medical University and Guangdong Key Laboratory of Urology, Guangzhou, China.
Department of Urology, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
出版信息
J Urol. 2017 May;197(5):1289-1295. doi: 10.1016/j.juro.2017.01.001. Epub 2017 Jan 5.
PURPOSE
We assessed the efficacy and safety of external physical vibration lithecbole for the treatment of residual stones after retrograde intrarenal surgery.
MATERIALS AND METHODS
A total of 173 patients (128 males and 45 females) were selected for study. All patients had residual fragments after retrograde intrarenal surgery for renal or upper ureteral stones. They were prospectively randomized into 2 groups. One group underwent external physical vibration lithecbole 1 week after retrograde intrarenal surgery and the other underwent only retrograde intrarenal surgery as the control group. Stone size and location, stone-free rate and complications were compared.
RESULTS
Of 173 patients 87 (66 males and 21 females) were in the treatment group and 86 (62 males and 24 females) were in the control group. The stone-free rate in the treated and control groups 2 weeks after retrograde intrarenal surgery was 52.9% and 31.4%, at 3 weeks it was 71.3% and 51.2%, and at 5 weeks it was 89.7% and 59.3%, respectively (all p <0.05). The hematuria incidence 5 weeks after retrograde intrarenal surgery was 3.4% in the treated group compared to 20.9% in the control group (p <0.05). The incidence of positive urine leukocytes in the treated vs control groups was 4.6% vs 19.8% 3 weeks after retrograde intrarenal surgery and 3.4% vs 11.6% at 5 weeks (p <0.05).
CONCLUSIONS
External physical vibration lithecbole as a supplement to retrograde intrarenal surgery was more effective than retrograde intrarenal surgery alone in terms of stone clearance speed, stone-free rate and patient compliance.
目的
评估体外物理振动碎石术治疗经皮肾镜取石术后残余结石的疗效和安全性。
材料与方法
选择 173 例（男 128 例，女 45 例）患者，均为经皮肾镜取石术后肾或上段输尿管结石残留碎片患者。前瞻性随机分为两组，一组在经皮肾镜取石术后 1 周行体外物理振动碎石术，另一组仅行经皮肾镜取石术作为对照组。比较结石大小和位置、结石清除率和并发症。
结果
173 例患者中，87 例（男 66 例，女 21 例）为治疗组，86 例（男 62 例，女 24 例）为对照组。治疗组和对照组经皮肾镜取石术后 2 周、3 周、5 周结石清除率分别为 52.9%和 31.4%、71.3%和 51.2%、89.7%和 59.3%（均 P <0.05）。治疗组 5 周经皮肾镜取石术后血尿发生率为 3.4%，对照组为 20.9%（P <0.05）。治疗组和对照组经皮肾镜取石术后 3 周尿白细胞阳性率分别为 4.6%和 19.8%，5 周时分别为 3.4%和 11.6%（均 P <0.05）。
结论
体外物理振动碎石术作为经皮肾镜取石术的补充，在结石清除速度、结石清除率和患者依从性方面优于单纯经皮肾镜取石术。
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