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体外物理振动松解辅助体外冲击波碎石术后排净输尿管上段 1.0-2.0cm 结石:一项前瞻性随机试验。

External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy: a prospective randomized trial.

机构信息

Department of Urology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, 211100, Jiangsu, China.

出版信息

Urolithiasis. 2020 Feb;48(1):71-77. doi: 10.1007/s00240-018-1100-8. Epub 2018 Nov 28.

Abstract

To observe the efficacy and safety of External Physical Vibration Lithecbole (EPVL) in patients with upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy (ESWL). A total of 271 patients with upper ureteric stones 1.0-2.0 cm were prospectively randomized into two groups. One hundred and twenty-seven cases in the treatment group accepted EPVL therapy and 144 cases as control after ESWL. The stone expulsion status and stone-free rates (SFRs) between two groups were compared at the 1st, 2nd and 4th weekends by imaging examinations. All of 271 patients were randomly assigned to two groups, of which 127 patients were included in the treatment group and 144 in the control group. EPVL was successful in assisting the discharge of stone fragments. The rate of stone expulsion at day 1 in the treatment group was significantly higher than in the control group (79.5% vs. 64.6%, P = 0.006). The SFRs of the 1st weekend (76.3% vs. 61.8%, P = 0.010), the 2nd weekend (88.2% vs. 77.1%, P = 0.017) and the 4th weekend (92.1% vs. 84.0%, P = 0.042) in the treatment group were all significantly higher than that in the control group. However, no statistical significance was found in complications between the two groups (P > 0.05). Furthermore, in the treatment group the patients were treated a mean 4.3 sessions of EPVL. EPVL and ESWL are ideal complementary partners in the treatment of upper ureteric stones 1.0-2.0 cm, satisfying both high SFR and low complication. This method is safe and reproducible in clinical practice, and it also needs large-scale multicenter prospective studies further to prove the above conclusions.

摘要

观察体外物理振动碎石术(EPVL)对体外冲击波碎石术(ESWL)后 1.0-2.0cm 输尿管上段结石的疗效和安全性。将 271 例 1.0-2.0cm 输尿管上段结石患者前瞻性随机分为两组。治疗组 127 例接受 EPVL 治疗,ESWL 后对照组 144 例。通过影像学检查比较两组第 1、2、4 周末结石排出情况及结石清除率(SFR)。271 例患者均随机分为两组,其中治疗组 127 例,对照组 144 例。EPVL 成功辅助结石排出。治疗组第 1 天结石排出率明显高于对照组(79.5%比 64.6%,P=0.006)。第 1 周末(76.3%比 61.8%,P=0.010)、第 2 周末(88.2%比 77.1%,P=0.017)及第 4 周末(92.1%比 84.0%,P=0.042)的 SFR 治疗组均明显高于对照组。但两组并发症比较无统计学意义(P>0.05)。此外,治疗组患者平均接受 EPVL 治疗 4.3 次。EPVL 和 ESWL 是治疗 1.0-2.0cm 输尿管上段结石的理想互补伙伴,既能达到较高的 SFR,又能降低并发症。该方法在临床实践中安全且可重复,需要进一步进行大规模多中心前瞻性研究来证明上述结论。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b87/6989669/1eb4baae4603/240_2018_1100_Fig1_HTML.jpg

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