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电针结合体外冲击波碎石术有利于输尿管结石的排出:一项前瞻性随机试验。

Electroacupuncture combined with extracorporeal shock wave lithotripsy is beneficial for the expulsion of ureteral calculi: a prospective randomized trial.

机构信息

Department of Urology, Shandong Provincial Third Hospital, Shandong University, No. 12, Wuyingshan Middle Road, Jinan, Shandong, China.

Department of Acupuncture-Moxibustion and Tuina, Shandong Provincial Third Hospital, Shandong University, No. 12, Wuyingshan Middle Road, Jinan, Shandong, China.

出版信息

World J Urol. 2024 Sep 9;42(1):512. doi: 10.1007/s00345-024-05226-4.

Abstract

PURPOSE

To evaluate the therapeutic efficacy and safety of electroacupuncture (EA) combined with extracorporeal shock wave lithotripsy (ESWL) in treating ureteral calculi.

METHODS

This prospective randomized controlled trial included 207 patients with ureteral calculi who were randomly allocated to an experimental group that underwent EA plus ESWL (n = 95) and a control group that underwent only ESWL (n = 112). Imaging examinations were performed at 1, 2, and 4 weeks after the operation, followed by comparing the stone-clearance rate, time to first stone expulsion, and incidence of major complications between the two groups.

RESULTS

The stone-clearance rates at 1 (59.1 vs. 37%, P = 0.002), 2 (86.4 vs. 59.3%, P = 0.000), and 4 (90.9 vs. 77.8%, P = 0.013) weeks after the operation in the experimental group were significantly higher than those in the control group. The time to first stone expulsion in the experimental group was significantly lower than that in the control group (1.29 ± 1.55 vs. 2.45 ± 3.11 days, respectively; P = 0.001). However, we found no difference in the incidence of major complications between the two groups (15.9 vs. 17.6%, P = 0.754).

CONCLUSION

EA-assisted ESWL significantly improved stone clearance and shortened the time to stone expulsion without elevating the complication risk. However, a large-scale multicenter, prospective study is required to corroborate our conclusions.

摘要

目的

评估电针(EA)联合体外冲击波碎石术(ESWL)治疗输尿管结石的疗效和安全性。

方法

本前瞻性随机对照试验纳入 207 例输尿管结石患者,随机分为 EA+ESWL 实验组(n=95)和仅 ESWL 对照组(n=112)。术后 1、2、4 周进行影像学检查,比较两组结石清除率、首次排石时间和主要并发症发生率。

结果

实验组术后 1、2、4 周的结石清除率分别为 59.1%比 37%(P=0.002)、86.4%比 59.3%(P=0.000)和 90.9%比 77.8%(P=0.013),明显高于对照组。实验组首次排石时间明显短于对照组(分别为 1.29±1.55 天比 2.45±3.11 天,P=0.001)。但两组主要并发症发生率无差异(15.9%比 17.6%,P=0.754)。

结论

EA 辅助 ESWL 可显著提高结石清除率,缩短排石时间,且不增加并发症风险。但需要大样本、多中心的前瞻性研究来验证我们的结论。

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