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[肾结石患者在肾切开取石术或体外冲击波碎石术中预防肾脏损伤的方法]

[Ways of prevention of kidney lesions during nephrolithotomy or extracorporeal lithotripsy in nephrolithiasis].

作者信息

Kazachenko A V, Dzeranov N K, Ianenko E K, Beshliev D A, Golovanov S A

出版信息

Urol Nefrol (Mosk). 1998 Jul-Aug(4):10-3.

PMID:9727313
Abstract

Outcomes of nephrolithiasis treatment depend not only on renal dysfunction resultant from abnormal urine passage and concomitant infection but also on intraoperative mechanical trauma and ischemia. To compare renal damage induced by nephrolithotomy with that of shock-wave lithotripsy and effects of chemotherapy, 54 patients with nephrolithiasis were divided into 2 groups and 2 subgroups. Patients of group 1 underwent nephrolithotomy, those of group 2--extracorporeal shock-wave lithotripsy (ESWL). Subgroups "a" in both groups received no chemotherapy, subgroups "b" were treated with alpha-tocopherol, pentoxifylline, indomethacin. ESWL was found less traumatic. Postoperative drug prophylaxis promoted more pronounced inhibition of lipid peroxidation products and urinary enzymes activity, contributing to lessening of the operative trauma. Anti-ischemic protection of the kidneys also improved renal function.

摘要

肾结石治疗的结果不仅取决于因尿液排出异常和并发感染导致的肾功能障碍,还取决于术中的机械创伤和局部缺血。为比较肾切开取石术与冲击波碎石术所致的肾损伤以及化疗的效果,将54例肾结石患者分为2组及2个亚组。第1组患者接受肾切开取石术,第2组患者接受体外冲击波碎石术(ESWL)。两组中的“a”亚组未接受化疗,“b”亚组用α-生育酚、己酮可可碱、吲哚美辛治疗。结果发现ESWL的创伤性较小。术后药物预防更显著地抑制了脂质过氧化产物和尿酶活性,有助于减轻手术创伤。肾脏的抗缺血保护也改善了肾功能。

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