静脉水化碱化疗法治疗尿酸性肾石病的研究  

Clinical research on curative effect of treatment on patients with gouty renal stone by hydration-alkalization therapy

作　　者：毛宁[1] 刘颖[1,2] MAO Ning;LIU Ying(Hangzhou,Zhejiang Province,310007,China;Department of Endocrinology,Airport Road District of No.903 Hospital of People's Liberation Army,Hangzhou,310004,Zhejiang Province,China)

机构地区：[1]安徽医科大学解放军杭州临床学院 [2]解放军第九〇三医院机场路内分泌科,浙江杭州310004

出　　处：《海南医学院学报》2019年第8期614-617,共4页Journal of Hainan Medical University

基　　金：浙江省医药卫生科技计划项目(2013KYA177)~~

摘　　要：目的:研究静脉水化碱化疗法治疗尿酸性肾石病的临床疗效。方法:以2年来内分泌科累积收治并确诊为尿酸性肾石病65例患者的86个结石肾为研究对象,采用随机数字表分为对照组(n=31)和治疗组(n=34)。两组均予以低嘌呤饮食等基础治疗,对照组予以口服碳酸氢钠片+口服补液1 000 mL/日治疗,治疗组予以0.9%生理盐水500 mL+5%碳酸氢钠注射液60 mL+10%氯化钾注射液10 mL静滴,水化碱化治疗2次/日,两组均治疗1个疗程(10 d),分别于治疗前后检测相关实验室指标及影像学检查,评估治疗效果。结果:治疗组总有效率86.67%,显效率68.89%,小于0.5 cm肾脏小结石治疗后显效率明显优于对照组(P<0.01)。治疗组治疗前25例患者eGFR降低,水化碱化治疗后eGFR明显升高、血肌酐下降,差异有统计学意义(P<0.05)。结论:静脉水化碱化疗法治疗尿酸性肾石病临床疗效显著,可以碱化尿液,降低血尿酸水平。直径小于0.5 cm结石消失,直径0.5～0.8 cm结石明显缩小,改善结石相关肾功能不全,费用低廉,值得临床广泛推广。Objective:To study the clinical efficacy of intravenous hydration of alkaline phosphatase in the treatment of uric acid nephrolithiasis.Methods:Sixty-five patients with 86 stones admitted to Department of Endocrinology and Urinary Nephropathy from December 2015 to December 2017 in our hospital were divided into control group(n=31)and Treatment group(n=34 cases)with random number table.Both groups were given basic treatment with low purine diet and the control group was treated with oral sodium bicarbonate tablets+oral rehydration 1 000 mL/day.The treatment group was treated with Hydration alkalosis treatment by 0.9%saline 500 mL+5%sodium bicarbonate Injection of 60 mL+10%potassium chloride injection 10 mL intravenous infusion,2 times/d.Two groups were treated for a course of treatment(10 d),respectively,detecting relevant laboratory parameters and imaging studies before and after treatment for assessing the effectiveness of treatment.Results:The total effective rate of the treatment group was 86.67%,which was significantly better than the control group(4.88%)(P<0.01).Conclusion:It is a significant effect that Intravenous hydration alkalosis therapy for the treatment of uric acid nephrolithiasis.The diameter of less than 0.5 cm stones disappears,and the diameter of 0.5-0.8 cm stone was significantly reduced.as it can improve stone related renal insufficiency with low cost,it is widely recommended in clinical.

关 键 词：静脉水化碱化疗法 尿酸性肾石病 疗效 

分 类 号：R692.4[医药卫生—泌尿科学] R589.7[医药卫生—外科学]