体外冲击波碎石术中间断操作对急性肾损伤的保护作用  

Protective effect of different renal protection protocols on acute kidney injury after extracorporeal shock wave lithotripsy

作　　者：张向凯[1] 邵晋凯[1] 问晓东[1] Zhang Xiangkai;Shao Jinkai;Wen Xiaodong(Department of Urology Surgery,Shanxi Provincial People＇s Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院泌尿外科,太原030012

出　　处：《中国实用医刊》2018年第21期13-15,共3页Chinese Journal of Practical Medicine

摘　　要：目的 探讨不同肾保护治疗方案对体外冲击波碎石术后急性肾损伤的影响.方法 选取2016年7月至2017年12月山西省人民医院收治的156例孤立型肾结石患者（结石直径〈15 mm）,采用随机数字表法分为A、B、C组,每组52例.A组从开始到治疗结束均使用推荐肾结石治疗的80％最大功率;B组前100个冲击波（SWS）采用80％功率,停顿3 min,然后以80％功率直到治疗结束;C组前100个冲击波（SWS）采用80％功率,停顿3 min,然后以40％功率直到治疗结束.于术后第2天通过影像学检查评估肾血肿的发生率;同时采集尿标本测定治疗前后急性肾损伤标志物.结果 三组患者基线信息和治疗参数比较差异未见统计学意义（P〉0.05）.三组血肿发生率分别为15.3％、13.4％、9.6％,差异未见统计学意义（P〉0.05）.三组各项急性肾损伤标志物指标术后均升高,且B、C组各项急性肾损伤标志物低于A组（P〈0.05）.结论 体外冲击波碎石过程中进行操作暂停有助于减少术后急性肾损伤,值得推广应用.Objective To investigate the effects of different renal protection protocols on acute kidney injury after extracorporeal shock wave lithotripsy .Methods A total of 156 patients with isolated renal calculi （ calculi diameter 〈15 mm） who were treated in Shanxi Provincial People ＇s Hospital from July 2016 to December 2017 were selected .And the patients were divided into group A , group B and group C by random number table method , with 52 cases in each group .The 80％ peak-power from the beginning to the end of the treatment was used in group A;the first 100 shock waves （ SWS ） were with 80％peak-power, paused 3 min, and then restarted SWS with 80％ peak-power until to the end of the treatment in group B;the first 100 shock waves （SWS） were with 80％peak-power, paused 3 min, then restarted SWS with 40％peak-power until to the end of the treatment in group C .The incidence of renal hematoma was assessed on the second day after operation , and the urine samples were collected for determination of markers of acute kidney injury before and after treatment .Results There was no significant difference in baseline information or treatment parameters among the three groups （ P〉0.05 ） . The incidence of hematoma of the three groups was 15.3％, 13.4％, 9.6％, respectively , and there was no significant difference among the three groups （ P〉0.05 ） .In addition , the indicators of acute kidney injury in the three groups were increased after operation , and the acute kidney injury markers in group B and group C were lower than those in group A （ P〈0.05 ） .Conclusions Operation suspension in the process of extracorporeal shock wave lithotripsy is conductive to reduction of acute renal injury after operation, and it is worth popularizing .

关 键 词：不同参数 体外冲击波碎石 急性肾损伤 

分 类 号：R699[医药卫生—泌尿科学]