Skolarikos Andreas
Associate Professor of Urology, National and Kapodistrian University of Athens, Athens, Greece.
Curr Opin Urol. 2018 Sep;28(5):403-407. doi: 10.1097/MOU.0000000000000523.
To identify the latest progression on medical treatment of urinary stones.
Nonsteroidal anti-inflammatory drugs should be the preferred analgesic option for patients presenting to the emergency department with renal colic. A-blockers could be of patient benefit when used for distal ureteral stones more than 5 mm in size. However, the quality of the randomized controlled studies on medical expulsive therapy (MET) is still low based on the Consolidated Standards for Reporting Trials (CONSORT) criteria. MET should be used with caution in children and pregnant women. In patients with renal stones, the evaluation of the comorbidities of developing chronic Kidney Disease (CKD) or End Stage Renal Disease (ESRD) is mandatory. It is highly recommended to follow the European Association of Urology Urolithiasis Guidelines Panel Diagnostic and Therapeutic algorithms to prevent stone recurrence.
Medical treatment of urinary stone disease should be supported by well designed higher level of evidence clinical research.
确定尿路结石医学治疗的最新进展。
对于因肾绞痛就诊于急诊科的患者,非甾体类抗炎药应作为首选的镇痛药物。α受体阻滞剂用于治疗直径大于5毫米的远端输尿管结石时可能对患者有益。然而,根据试验报告统一标准(CONSORT)标准,关于药物排石疗法(MET)的随机对照研究质量仍然较低。儿童和孕妇应谨慎使用MET。对于肾结石患者,必须评估发生慢性肾脏病(CKD)或终末期肾病(ESRD)的合并症。强烈建议遵循欧洲泌尿外科学会尿石症指南小组的诊断和治疗算法以预防结石复发。
尿路结石疾病的医学治疗应得到设计良好、证据水平更高的临床研究的支持。