Application of double pulse extracorporeal shock wave lithotripsy residual kidney stones after PCNL
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摘要:
目的总结复式脉冲体外冲击波碎石(ESWL)在PCNL术后残留肾结石治疗的应用体会。 方法回顾性分析我中心3265例行复式脉冲体外冲击波碎石术治疗的肾结石患者的临床资料，实验组为微创经皮肾镜碎石术后残留肾结石患者，共计896例，对照组为单纯ESWL治疗肾结石患者，共计2369例。分析两组患者结石治疗的有效率、治愈率及术后并发症等因素。 结果实验组患者进行2次以上ESWL治疗的比例较单纯ESWL治疗组低，结石排出率较单纯ESWL治疗组高。在并发症方面，两组患者术后发生肉眼血尿、术后感染、肾脏包膜下或实质内血肿及肾功能不全的比例相当。但是，实验组患者其治疗后发生肾绞痛及形成石街的比例较单纯ESWL治疗组低。 结论复式脉冲体外冲击波碎石术对PCNL术后残留结石患者的治疗创伤小、成功率高、严重并发症少，是处理上尿路残留结石有效治疗手段之一。 Abstract:ObjectiveTo summarize the application experience of double pulse extracorporeal shock wave lithotripsy (ESWL) in the treatment of residual kidney calculus after PCNL operation. MethodsThe clinical data of 3265 kidney calculus patients underwent ESWL were analyzed retrospectively. The patients of residual kidney calculus after mini-PCNL as experimental group (n=896) and the patients who underwent simply ESWL as control group (n=2369). The effective rate, cure rate and complications were compared. ResultsThe proportion of patients in the experimental group than ESWL treatment for secondary low ESWL treatment group compared to the simple, high stone expulsion rate than pure ESWL treatment groups. In terms of complications, postoperative occurrence of gross hematuria, postoperative infection, under the kidney capsule or renal parenchymal hematoma considerable proportion of dysfunction. However, the experimental group after the treatment of patients with renal colic and proportion than the pure form of Stone Street ESWL treatment group is low. ConclusionThe double pulse extracorporeal shock wave lithotripsy for the treatment of patients with residual stones after PCNL less invasive, high success rate, less serious complications, is one of the effective treatment of upper urinary tract calculus. -
表 1 两组ESWL治疗有效率比较
1次ESWL 2次ESWL 3次ESWL 总有效率 总治愈率 实验组 91.3% 6.9% 1.8% 89.8% 82.0% 对照组 88.0% 8.9% 2.1% 87.4% 73.1% P 0.007 0.067 0.042 0.053 0.000 
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表 2 两组ESWL治疗后不良反应比较
肉眼血尿 肾绞痛 术后感染 肾包膜下血肿 石街形成 肾功能损害 实验组 85.2% 10.6% 1.67% 0.22% 0.22% 0.22% 对照组 83.5% 21.1% 1.52% 0.13% 1.01% 0.17% P 0.249 0.000 0.751 0.529 0.024 0.746
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