ESWL和F-URS在不同体质量儿童肾结石病人中的应用  

Application of ESWL and F-URS in pediatric nephrolithiasis patients with different body mass

作　　者：王君 梁宇 郑金一 李海波 王茂富 董志强 李松 WANG Jun;LIANG Yu;ZHENG Jin-yi;LI Hai-bo;WANG Mao-fu;DONG Zhi-qiang;LI Song(Department of Urology,The 901st Hospital of The Joint Logistics Support Force of PLA,Hefei Anhui 230031,China)

机构地区：[1]解放军联勤保障部队第901医院泌尿外科,安徽合肥230031

出　　处：《蚌埠医学院学报》2022年第7期905-908,911,共5页Journal of Bengbu Medical College

摘　　要：目的:探讨体外冲击波碎石术(ESWL)与输尿管软镜碎石术(F-URS)在不同体质量儿童肾结石病人中的应用价值。方法:选取单发性儿童肾结石病人为研究对象,根据结石大小、体质量指数(BMI)及个人意愿共纳入41例,依据BMI分为超重组(BMI≥24.0 kg/m^(2))20例和非超重组(BMI<24.0 kg/m^(2))21例,2组再根据治疗方式不同各分为ESWL组(采用ESWL治疗)和F-URS组(采用F-URS联合钬激光碎石术治疗)2个亚组。分别比较超重组和非超重组不同治疗方式亚组的术后常见并发症(术后一过性血尿、术后发热)、一次碎石成功率及术后置入双J管情况。结果:在非超重组中,ESWL组病人术后一过性血尿和术后发热发生率、置入双J管病人例数均低于F-URS组(P<0.05),2组一次碎石成功率差异均无统计学意义(P>0.05)。在超重组中,F-URS组病人一次碎石成功率高于ESWL组(P<0.05),2组术后一过性血尿和术后发热发生率、置入双J管病人例数差异均无统计学意义(P>0.05)。结论:在非超重儿童肾结石病人中,ESWL与F-URS治疗效果相似,可根据病人情况或医院偏好选择。在超重儿童肾结石病人中,ESWL治疗效果下降,F-URS具有稳定的碎石效果,更适合超重病人。Objective:To investigate the application value of extracorporeal shock wave lithotripsy(ESWL)and flexible ureteroscope(F-URS)lithotripsy in pediatric nephrolithiasis patients with different body mass.Methods:A total of 41 cases with single pediatric nephrolithiasis were included according to stone size body mass index(BMI)and personal intention.According to BMI,the patients were divided into overweight group(BMI≥24.0 kg/m^(2),n=20)and non-overweight group(BMI<24.0 kg/m^(2),n=21).The patients in the two groups were further divided into two subgroups including ESWL group(treated with ESWL)and F-URS group(treated with F-URS combined with holmium laser lithotripsy)according to the treatment method.The common postoperative complications(transient hematuria and postoperative fever),the success rate of one-time lithotripsy and the placement of double-J catheter after operation were compared between subgroups with different treatment method in overweight group and non-overweight group,respectively.Results:In the non-overweight group,the incidence of transient hematuria and postoperative fever,and the number of patients with double-J catheter in the ESWL group were lower than those in the F-URS group(P<0.05),and there was no significant difference in the success rate of one-time lithotripsy between the two groups(P>0.05).In the overweight group,the success rate of one-time lithotripsy in the F-URS group was higher than that in the ESWL group(P<0.05),and there was no significant difference in the incidence of transient hematuria and postoperative fever,and the number of patients with double-J catheter between the two groups(P>0.05).Conclusions:In non-overweight patient with pediatric nephrolithiasis,ESWL and F-URS have similar therapeutic effects,which can be selected according to the patient′s condition or hospital preference.In overweight patient with pediatric nephrolithiasis,the treatment effect of ESWL decreases,while F-URS has a stable lithotripsy effect and is more suitable for overweight patient.

关 键 词：肾结石 体外冲击波 输尿管软镜 体质量指数 儿童 

分 类 号：R669.2[医药卫生—外科学]