| 陈嘉兴,胡凌云,彭军,姜希富,王超洋.物理振动排石与体外冲击波碎石治疗输尿管下段小结石的临床比较[J].浙江中西医结合杂志,2021,31(3): |
| 物理振动排石与体外冲击波碎石治疗输尿管下段小结石的临床比较 |
| Clinical Comparison of External Physical Vibration Lithecbole and Extracorporeal Shock Wave Lithotripsy in The Treatment of Small Ureteral Calculi |
| 投稿时间：2020-08-30 修订日期：2021-01-20 |
| DOI： |
| 中文关键词: 振动 冲击波，输尿管，下段，泌尿系结石 |
| 英文关键词:Vibration Shock Wave, Ureter, Lower Segment, Urinary Calculi |
| 基金项目:衢州市科技计划指导项目 |
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| 中文摘要: |
| 目的 比较物理振动排石术(External Physical Vibration Lithecbole,EPVL)与体外冲击波碎石术(extracorporeal shock wave lithotripsy, ESWL)治疗输尿管下段小结石的临床疗效。方法 我院2019年05月至2020年06月期间被确诊为输尿管下段小结石的80例患者,前瞻性、随机分组,分为EPVL组和ESWL组,每组各40例,憋尿后行相关治疗。观察并统计各组情况变化,早晚体温和尿色变化,1周排净率、2周、4周排净率和并发症,术后1周、2周、4周后复查泌尿系B超和/或CT、血常规、尿常规、肾功能等。结果 ESWL组结石长径为4.00mm-6.00mm,EPVL组结石长径为3.50mm-6.00mm,结石长径无差异(P＞0.05),年龄、性别、BMI两组比较均无差异(P＞0.05)。单次击碎率,ESWL组和ESWL组分别为85.00%(34/40)、52.5%(21/40)。ESWL组1个月内8例结石未排净,总排净率为80.00%,1周、2周、4周后的排净率分别为75.00%(30/40)、5%(2/40)、0；而EPVL组1个月内8例结石未排净,总排净率为80.00%,1周、2周、4周后的排净率分别为60.00%(24/40)、10.00%(4/40)、10.00%(4/40)。发生并发症者共24例(24/80,30.00%),EPVL组4例(4/40,10.00%),ESWL组20例(20/40,50.00%),经积极治疗后均好转,无1例严重并发症,并发症ESWL组明显升高(P＜0.05)。结论 治疗输尿管下段小结石时,EPVL组和ESWL组,各有优势。单次结石击碎率ESWL组明显高于EPVL组(P＜0.01),治疗后的近期(1周)排净率,ESWL组高于EPVL组(P＜0.05),而中远期(2周、4周)排净率,ESWL组低于EPVL组(P＜0.05)；并发症的发生,ESWL组远高于EPVL组(P＜0.01)。 |
| 英文摘要: |
| Objective To compare the clinical efficacy of External Physical Vibration Lithecbole (EPVL) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of small ureteral calculi. Methods From May 2019 to June 2020 in our hospital,80 patients who were diagnosed with small ureteral calculi were prospectively and randomly divided into EPVL group and ESWL group, 40 cases in each group, and related after holding urine treatment. Observe and count the changes in each group, morning and evening changes in body temperature and urine color, 1 week, 2 weeks, 4 weeks, and complications, and recheck urinary B-ultrasound and urinary system 1 week, 2 weeks, and 4 weeks after surgery. /Or CT, blood test, urine test, renal function, etc. Results The long diameter of the stones in the ESWL group was 4.00mm-6.00mm, and the long diameter of the stones in the EPVL group was 3.50mm-6.00mm. There was no difference in the long diameter of the stones (P>0.05). There was no difference in age, gender and BMI between the two groups (P> 0.05). The single crushing rate was 85.00% (34/40) and 52.5% (21/40) in the ESWL group and ESWL group, respectively. In the ESWL group, 8 cases of stones were not cleared within 1 month, the total clearance rate was 80.00%, and the clearance rates after 1 week, 2 weeks, and 4 weeks were 75.00% (30/40) and 5% (2/40). ), 0; In the EPVL group, 8 cases of stones were not cleared within 1 month, the total clearance rate was 80.00%, and the clearance rates after 1 week, 2 weeks, and 4 weeks were 60.00% (24/40) and 10.00, respectively % (4/40), 10.00% (4/40). Complications occurred in 24 cases (24/80, 30.00%), 4 cases in the EPVL group (4/40, 10.00%), and 20 cases in the ESWL group (20/40, 50.00%). All improved after active treatment, none In 1 case of serious complications, the complications in the ESWL group were significantly higher (P<0.05).Conclusion When treating small ureteral calculi, EPVL group and ESWL group have their own advantages. The single stone crushing rate in the ESWL group was significantly higher than that in the EPVL group (P<0.01). The short-term (1 week) clearance rate after treatment was higher in the ESWL group than in the EPVL group (P<0.05), and the medium and long-term (2 weeks) , 4 weeks), the ESWL group was lower than the EPVL group (P<0.05); the incidence of complications, the ESWL group was much higher than the EPVL group (P<0.01). |
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