物理振动排石结合在X线定位下体外冲击波碎石对上尿路结石患者结石清除情况、症状改善及肾功能指标的影响

doi:10.3969/j.issn.1671-7171.2023.06.024

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摘要【目的】探讨物理振动排石结合在X线定位下行体外冲击波碎石(ESWL)对上尿路结石患者结石清除情况、症状改善及肾功能指标的影响。【方法】选取2019年2月至2021年3月西安宝石花长庆医院收治的126例上尿路结石患者,根据治疗方案不同将其分为对照组(在X线定位下行ESWL治疗,n=62)和观察组(在对照组的基础上联合物理振动排石治疗,n=64)。比较两组疗效、结石清除情况、症状改善情况、并发症发生情况,比较两组患者术前、术后3 d血清β2-微球蛋白(β2-MG)、胱抑素C(Cys C)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平。【结果】观察组总有效率为95.31%(61/64),高于对照组的83.87%(52/62),差异有统计学意义(χ²=4.455,P<0.05)。观察组术后1 d、1周、2周结石清除率均高于对照组,差异有统计学意义(P<0.05)。术后3 d,两组血清β2-MG、Cys C、NGAL水平均高于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。术后2周,两组血尿、腹痛、尿频、尿急及恶心、呕吐评分均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为10.94%(7/64),高于对照组的6.45%(4/62),但差异无统计学意义(χ²=0.795,P>0.05)。【结论】应用物理振动排石结合在X线定位下行ESWL治疗上尿路结石可提高结石清除率与临床疗效,促进症状改善和肾功能恢复,安全性好。

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	彭俊峰
	舒涛

关键词 ：尿路结石症/外科学, 尿路结石症/影像诊断, 碎石术, 肾功能试验

Abstract：【Objective】 To investigate the effects of physical vibration lithotripsy combined with X-ray guided extracorporeal shock wave lithotripsy (ESWL) on stone clearance,symptom improvement,and renal function indicators in patients with upper urinary tract stones. 【Methods】 A total of 126 patients with upper urinary tract stones admitted to the Xi'an Baoshi Hua Changqing Hospital from February 2019 to March 2021 were selected and divided into a control group (treated with ESWL under X-ray localization,n=62) and an observation group (treated with physical vibration lithotripsy on the basis of the control group,n=64) according to different treatment plans. The curative effect,stone clearance,symptom improvement and complications of the two groups were compared. The serum levels of β2-microglobulin (β2-MG),Cystatin C (Cys C) and neutrophil Gelatinase related lipid transporter (NGAL) were compared before and 3 days after surgery. 【Results】 The total effective rate of the observation group was 95.31% (61/64),which was higher than 83.87% (52/62) of the control group,with a statistically significant difference( χ² = 4.455,P<0.05). The stone clearance rate in the observation group was higher than that in the control group at 1 day,1 week,and 2 weeks after surgery,with a statistically significant difference (P<0.05). On the 3rd day after surgery,the serum levels of β2-MG,Cys C,and NGAL in both groups were higher than before surgery,and the observation group was lower than the control group,with statistically significant differences (P<0.05). Two weeks after surgery,the scores of hematuria,abdominal pain,urinary frequency,urgency,nausea,and vomiting in both groups were lower than before surgery,and the observation group was lower than the control group,with a statistically significant difference (P<0.05). The incidence of complications in the observation group was 10.94% (7/64),higher than the control group's 6.45% (4/62),but the difference was not statistically significant(χ²=0.795,P>0.05). 【Conclusion】 The application of physical vibration lithotripsy combined with X-ray localization ESWL in the treatment of upper urinary tract stones can improve the stone clearance rate and clinical efficacy,promote symptom improvement,accelerate renal function recovery,and have good safety.

Key words： Urolithiasis/SU Urolithiasis/DG Lithotripsy Kidney Function Tests

收稿日期: 2021-09-01

中图分类号:

R691.4

通讯作者: *E-mail:942815985@qq.com

引用本文:

彭俊峰, 舒涛. 物理振动排石结合在X线定位下体外冲击波碎石对上尿路结石患者结石清除情况、症状改善及肾功能指标的影响[J]. 医学临床研究, 2023, 40(6): 884-887.
PENG Jun-feng, SHU Tao. The Effect of Physical Vibration Lithotripsy Combined with X-ray Guided Extracorporeal Shock Wave Lithotripsy on Stone Clearance,Symptom Improvement,and Renal Function Indicators in Patients with Upper Urinary Tract Stones. JOURNAL OF CLINICAL RESEARCH, 2023, 40(6): 884-887.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.06.024 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I6/884

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