尿石症的医学管理：付出巨大努力但进展有限。
Medical management of urolithiasis: Great efforts and limited progress.
作者信息
Jahrreiss Victoria, Seitz Christian, Quhal Fahad
机构信息
Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
出版信息
Asian J Urol. 2024 Apr;11(2):149-155. doi: 10.1016/j.ajur.2023.05.001. Epub 2023 Jun 29.
OBJECTIVE
To provide a comprehensive review on the existing literature on medical management of urolithiasis.
METHODS
A thorough literature review was performed using Medline, PubMed/PMC, Embase, and the Cochrane Database of Systematic Reviews up to December 2022 to identify publications on the medical management of urolithiasis. Studies that assessed dietary and pharmacologic management of urolithiasis were reviewed; studies on medical expulsive therapy were not included in this review.
RESULTS
Medical management of urolithiasis ranges from the prophylactic management of kidney stone disease to dissolution therapies. While most treatment concepts have been long established, large randomized controlled trials are scarce. Dietary modification and increased fluid intake remain cornerstones in the conservative management of urolithiasis. A major limitation for medical management of urolithiasis is poor patient compliance.
CONCLUSION
Medical management of urolithiasis is more important in patients with recurrent urolithiasis and patients with metabolic abnormalities putting them at higher risk of developing stones. Although medical management can be effective in limiting stone recurrence, medical interventions often fail due to poor compliance.
目的
对尿石症医学管理的现有文献进行全面综述。
方法
截至2022年12月，使用Medline、PubMed/PMC、Embase和Cochrane系统评价数据库进行全面的文献检索，以确定关于尿石症医学管理的出版物。对评估尿石症饮食和药物管理的研究进行了综述；本综述未纳入关于药物排石治疗的研究。
结果
尿石症的医学管理范围从肾结石疾病的预防性管理到溶解疗法。虽然大多数治疗概念早已确立，但大型随机对照试验却很稀缺。饮食调整和增加液体摄入量仍然是尿石症保守治疗的基石。尿石症医学管理的一个主要限制是患者依从性差。
结论
尿石症的医学管理在复发性尿石症患者和有代谢异常使其患结石风险更高的患者中更为重要。虽然医学管理在限制结石复发方面可能有效，但由于依从性差，医学干预往往失败。
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