CAJ | 학술논문

目的观察上尿路结石体外冲击波碎石术(ESWL)术后物理振动排石机排石治疗的效果. 方法 2012年10月至2013年2月经ESWL碎石治疗后的上尿路结石患者133例,按交替随机分组法分为物理振动排石组和自然排石组.物理振动排石组66例,ESWL术后采用物理振动排石机治疗,结石位于肾中上盏6例、肾盂13例、肾下盏16例、输尿管31例,结石直径10～ 15 mm;自然排石组67例,ESWL术后采用多饮水、增加运动量等自然排石方法,结石位于肾中上盏8例、肾盂17例、肾下盏15例、输尿管27例,结石直径10～ 15 mm.两组患者性别、年龄、结石大小及分布比较差异均无统计学意义(P＞0.05).观察两组排石疗效、不良反应及并发症. 结果物理振动排石组平均排石治疗次数2.6次,治疗当天排石率77％ (51/66),1周结石排净率79％(52/66),肾下盏结石当天排石率81％(13/16),l周结石排净率88％(14/16)；自然排石组治疗当天排石率45％ (30/67),1周结石排净率49％ (33/67),肾下盏结石当天排石率33％(5/15),1周结石排净率40％(6/15)；组间比较差异均有统计学意义(P＜0.05).两组均无明显并发症发生. 结论物理振动排石机可明显促进ESWL治疗后的结石排出,对肾下盏结石的排石与传统方法比较疗效尤为显著.物理振动排石机治疗安全无创,未发现不良反应.
목적 관찰상뇨로결석체외충격파쇄석술(ESWL)술후물리진동배석궤배석치료적효과. 방법 2012년10월지2013년2월경ESWL쇄석치료후적상뇨로결석환자133례,안교체수궤분조법분위물리진동배석조화자연배석조.물리진동배석조66례,ESWL술후채용물리진동배석궤치료,결석위우신중상잔6례、신우13례、신하잔16례、수뇨관31례,결석직경10～ 15 mm;자연배석조67례,ESWL술후채용다음수、증가운동량등자연배석방법,결석위우신중상잔8례、신우17례、신하잔15례、수뇨관27례,결석직경10～ 15 mm.량조환자성별、년령、결석대소급분포비교차이균무통계학의의(P＞0.05).관찰량조배석료효、불량반응급병발증. 결과 물리진동배석조평균배석치료차수2.6차,치료당천배석솔77％ (51/66),1주결석배정솔79％(52/66),신하잔결석당천배석솔81％(13/16),l주결석배정솔88％(14/16)；자연배석조치료당천배석솔45％ (30/67),1주결석배정솔49％ (33/67),신하잔결석당천배석솔33％(5/15),1주결석배정솔40％(6/15)；조간비교차이균유통계학의의(P＜0.05).량조균무명현병발증발생. 결론 물리진동배석궤가명현촉진ESWL치료후적결석배출,대신하잔결석적배석여전통방법비교료효우위현저.물리진동배석궤치료안전무창,미발현불량반응.
Objective To observe the curative effect of external physical vibration lithecbole (EPVL) therapy after extracorporeal shock-wave lithotripsy (ESWL) in upper urinary calculi.Methods A total of 133 patients of upper urinary calculi with randomly divided into 2 groups after ESWL therapy during the period of 2012 October to 2013 February.The EPVL group (66 cases) used the physical vibration lithecbole treatment,and the natural lithecbole group (67 cases) used the method by drinking water,adding exercise and other natural lithecbole method.Of the EPVL group,6 of the stones were located in the upper or middle calyx,13 in renal pelvis,16 in lower renal calyx and 31 in ureter,the stone diameter was 10-15 mm.Of the natural lithecbole group,8 of the stones were located in the upper or middle calyx,17 in renal pelvis,15 in lower renal calyx and 27 in ureter,the stone diameter was 10-15 mm.The clinical data of the curative effect,side-effect,and complications were collected and analyzed systematically.Results In the EPVL group,the average times of lithagogue treatment was 2.6 times,51 patients (77％) expelled stones on the day of lithecbole,and the stone free rate in a week was 79％ (52/66).Especially,81％ (13/16) of the lower renal calyx expelled stones on the day of lithecbole,and the stone free rate in a week was 88％ (14/16).Whereas,30 patients (45％) in the natural lithecbole group expelled stones on the day of ESWL,and the stone free rate in a week was 49％ (33/67) ; the lower renal calyx stone expulsion rate on the day of ESWL was 33％ (5/15),and the stone free rate in a week was 40％ (6/15).The curative effects were significantly different between the 2 groups (P＜ 0.05).There were no serious complications in both groups.Conclusions EPVL machine can significantly promote the stone expulsion after ESWL.Compared with traditional methods,EPVL therapy has a better curative effect,especially on lower renal calyx stones.EPVL is a safe and noninvasive treatment.