体外冲击波碎石术联合物理振动排石治疗肾下盏结石的临床研究  

Clinical study on extracorporeal shock wave lithotripsy combined with external physical vibration lithecbole in the treatment of lower calyceal calculus

作　　者：孙海鹏 沈善林 陈洪延[1] 褚艳辉 刘思远[2] SUN Haipeng;SHEN Shanlin;CHEN Hongyan;CHU Yanhui;LIU Siyuan(Department of Urology Surgery,Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250011,China;School of Rehabilitation Medicine,Shandong University of Traditional Chinese Medicine,Jinan,Shandong 250355,China)

机构地区：[1]山东中医药大学附属医院泌尿外科,济南250011 [2]山东中医药大学康复医学院,济南250355

出　　处：《重庆医学》2023年第16期2448-2452,共5页Chongqing medicine

基　　金：山东省中医药科技项目(2021Q076)。

摘　　要：目的评估体外冲击波碎石术(ESWL)联合物理振动排石(EPVL)治疗肾下盏结石的有效性和安全性。方法收集山东中医药大学附属医院2021年4月至2022年6月应用双层压电式碎石机进行ESWL治疗的肾下盏结石患者60例,结石直径0.5~2.0 cm。将患者分为两组:观察组30例患者在ESWL后采用EPVL治疗,对照组30例患者在ESWL后采用常规排石治疗。EPVL在无麻醉状态下进行,ESWL及EPVL均由同一团队完成。比较两组患者的基线资料;术后随访28 d,比较两组患者术后第1、14和28天的排石率,以及无石率(SFR)、复治率和并发症发生率等。结果两组基线资料比较,差异均无统计学意义(P>0.05)。观察组SFR为83.3%,对照组为56.7%,差异有统计学意义(P<0.05)。观察组术后第1天排石率为86.7%、术后复治率为13.3%,对照组分别为46.7%、36.7%,差异均有统计学意义(P<0.05)。观察组术后第14、28天结石排出率分别为93.3%、93.3%,对照组分别为90.0%、93.3%,差异均无统计学意义(P>0.05)。两组患者术后均未出现感染性休克、心血管意外等严重并发症,两组肉眼血尿、发热、疼痛、输尿管石街等并发症发生率比较,差异均无统计学意义(P>0.05)。结论ESWL联合EPVL治疗肾下盏结石安全有效,相较ESWL联合常规排石,其SFR高、复治率低。Objective To evaluate the efficacy and safety of extracorporeal shock wave lithotripsy(ESWL)combined with external physical vibration lithotripter(EPVL)in the treatment of lower calyceal calculus.Methods From April 2021 to June 2022,a total of 60 patients with lower calyceal calculus who underwent ESWL treatment by double-layer piezoelectric lithotriptor in the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were collected,and the patients’stone diameter was 0.5-2.0 cm.The patients were divided into two groups:30 patients in the observation group were treated with EPVL after ESWL,while 30 patients in the control group were treated with routine method of removing residual stone after ESWL.EPVL was performed without anesthesia.ESWL and EPVL were completed by the same team.The baseline data of the two groups were compared.The patients were followed up for 28 days.The stone removal rate at 1,14,and 28 days after operationon,stone-free rate(SFR),retreatment rate,and the incidence of complications were compared between the two groups.Results There was no significant difference in baseline data between the two groups(P>0.05).The SFR was 83.3% in the observation group and 56.7% in the control group,with a statistically significant difference(P<0.05).At 1 day after operation,the stone removal rate in the observation group was 86.7%,and the retreatment rate was 13.3%,while those in the control group were 46.7% and 36.7% respectively,the differences were statistically significant(P<0.05).The stone removal rate of the observation group was 93.3% and 93.3% at 14,28 days after operation,and that of the control group was 90.0% and 93.3%.There was no significant difference between the two groups(P>0.05).No severe complications such as septic shock and cardiovascular accidents occurred in all patients after operation.There was no significant difference in the incidence of complications,including gross hematuria,fever,pain,and ureteral stone street,between the two groups(P>0.05).Conclusion ESWL combine

关 键 词：肾下盏结石 体外冲击波碎石术 物理振动排石 双层压电碎石机 

分 类 号：R692.4[医药卫生—泌尿科学]