Prosiannikov M Yu, Shaderkin I A, Konstantinova O V, Anokhin N V, Voytko D A, Nikushina A A
N.A. Lopatkin Scientific Research Institute of Urology and Interventional Radiology Branch of the National Medical Research Centre of Radiology of the Ministry of Health of Russian Federation.
Moscow, Russia.
Urologiia. 2019 Jul(3):60-65.
Oral dissolution therapy has been successfully used in urologic practice since 1950s. However, many doctors attempt to improve efficiency of this approach. Use of different medical personalized digital devices which are increasingly used in clinical practice, represent one of the solutions of this problem.
Our aim was to assess efficiency of oral dissolution therapy with drug Blemaren in patients with uric acid stones using of portable urinary analyzer with system of remote monitoring.
A total of 12 patients with uric acid stones were followed. All of them had kidney stone with a density less than 500 HU according to CT-urography. Oral dissolution therapy was performed with the drug Blemaren for 8-9 weeks. All patients were advised to maintain urine pH of 6.5-7.0. With aim of dynamic monitoring of urine parameters, a portable urine analyzer "ETTA AMP-01" was given to all patients for 2 months.
Complete dissolution was achieved in 10 (83.3%) patients. In one case (8.3%) oral dissolution therapy was complicated by acute pyelonephritis. A stenting was performed and dissolution therapy was continued with a positive effect. In another case (8.3%) partial dissolution was seen, however, extracorporeal shockwave lithotripsy was decided to perform. Doctor who remotely monitored different parameters of urinalysis (n=11) followed urine pH, density, leukocytes, erythrocytes, level of nitrite, which provided a more comprehensive assessment of patients current state. If necessary, the specialist contacted the patient and adjusted the therapy.
The possibility of remote monitoring of urinalysis and simple communication with urologist allows to titrate drug dose more convenient compared to conventional approach when outpatient urologist controls pH diaries based on dip-stick test. Moreover, such approach gives an opportunity to quickly identify complications and correct the therapy in a timely manner.
自20世纪50年代以来，口服溶石疗法已在泌尿外科实践中成功应用。然而，许多医生试图提高这种方法的效率。使用越来越多地用于临床实践的不同医疗个性化数字设备是解决这个问题的方法之一。
我们的目的是评估使用带有远程监测系统的便携式尿液分析仪，对尿酸结石患者进行药物Blemaren口服溶石治疗的效率。
共对12例尿酸结石患者进行了随访。根据CT尿路造影，他们所有人的肾结石密度均小于500 HU。使用药物Blemaren进行口服溶石治疗8-9周。建议所有患者将尿液pH值维持在6.5-7.0。为了动态监测尿液参数，给所有患者提供了便携式尿液分析仪“ETTA AMP-01”，为期2个月。
10例（83.3%）患者结石完全溶解。1例（8.3%）口服溶石治疗并发急性肾盂肾炎。进行了支架置入术，并继续溶石治疗，效果良好。另一例（8.3%）出现部分溶解，然而，决定进行体外冲击波碎石术。远程监测尿液分析不同参数的医生（n = 11）跟踪尿液pH值、密度、白细胞、红细胞、亚硝酸盐水平，这提供了对患者当前状态更全面的评估。如有必要，专家会联系患者并调整治疗方案。
与传统方法相比，尿液分析远程监测和与泌尿外科医生简单沟通的可能性使得滴定药物剂量更加方便，传统方法是门诊泌尿外科医生根据试纸测试控制pH值日记。此外，这种方法有机会快速识别并发症并及时纠正治疗方案。
