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输尿管软镜单独及联合体外物理振动治疗上尿路结石的疗效:一项随机对照试验

Therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi: a randomized controlled trial.

作者信息

Tan Cheng, Jiang Yongbao, Song Shanshan, Li Xiaoge, Zhou Chunliang

机构信息

Medical Examination Centre, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang Province, China.

Department of Urology, Ningbo Urology and Nephrology Hospital, Ningbo University, Ningbo, Zhejiang Province, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2021 Sep;16(3):536-542. doi: 10.5114/wiitm.2021.106425. Epub 2021 May 25.

Abstract

INTRODUCTION

Upper urinary tract calculus is a common disease of the urinary system.

AIM

To compare the therapeutic effects of flexible ureteroscopy alone and in combination with external physical vibration on upper urinary tract calculi.

MATERIAL AND METHODS

A total of 146 patients were randomly divided into control and experimental groups (n = 73). The control group received flexible ureteroscopy lithotripsy, and the experimental group underwent the same but combined with external physical vibration. The rate of finding stones in the urine on the day after treatment, clearance rate, components of stones, levels of renal function indices blood urea nitrogen (BUN) and serum creatinine (Scr), and incidence of complications were compared. The stone-free rate during 1-year follow-up was analysed by Kaplan-Meier method.

RESULTS

The rate of finding stones in the urine on the day after treatment was higher in the experimental group (100%) than that in the control group (29.73%) (p < 0.05). The clearance rates on the day, at 1 week, and at 2 weeks after treatment in the experimental group were 71.23%, 87.67%, and 95.89%, respectively, which surpassed those of the control group at corresponding time points (p < 0.05). BUN and Scr levels decreased after treatment in both groups, especially in the experimental group (p < 0.05). The stone-free rate during 1-year follow-up in the experimental group (n = 71 (97.26%)) exceeded that of the control group (n = 61 (83.56%)) (p < 0.05).

CONCLUSIONS

External physical vibration combined with flexible ureteroscopy lithotripsy significantly increased the rate of finding stones in the urine the day after treatment, the clearance rate of upper urinary tract calculi, and the ameliorated renal function and reduced the stone re-formation rate.

摘要

引言

上尿路结石是泌尿系统的常见疾病。

目的

比较单纯软性输尿管镜与联合体外物理振动治疗上尿路结石的疗效。

材料与方法

将146例患者随机分为对照组和试验组(n = 73)。对照组接受软性输尿管镜碎石术,试验组在接受相同治疗的基础上联合体外物理振动。比较两组治疗后次日尿中结石发现率、结石清除率、结石成分、肾功能指标血尿素氮(BUN)和血清肌酐(Scr)水平以及并发症发生率。采用Kaplan-Meier法分析1年随访期内的无石率。

结果

试验组治疗后次日尿中结石发现率(100%)高于对照组(29.73%)(p < 0.05)。试验组治疗当日、1周和2周后的结石清除率分别为71.23%、87.67%和95.89%,均高于对照组相应时间点的清除率(p < 0.05)。两组治疗后BUN和Scr水平均下降,试验组下降更明显(p < 0.05)。试验组1年随访期内的无石率(n = 71(97.26%))高于对照组(n = 61(83.56%))(p < 0.05)。

结论

体外物理振动联合软性输尿管镜碎石术可显著提高治疗后次日尿中结石发现率、上尿路结石清除率,改善肾功能,降低结石复发率。

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