半酸溶性鹿角型肾结石的微创治疗。

I Wall, H Tiselius, E Hellgren
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引用次数: 0

摘要

78例半酸溶性鹿角型肾结石患者中,23例采用经皮减囊术和高能体外冲击波碎石术(ESWL)联合治疗(a组);单纯高能ESWL治疗17例(B组);38例仅采用低能ESWL (C组)。所有患者均行经皮肾造口术,ESWL后行半酸素冲洗。A组和B组在麻醉下进行体外冲击波碎石,c组不麻醉。A组和B组在体外冲击波碎石的次数和住院时间上没有差异,出院时和6个月随访时的治疗结果是相似的,两组中59%的患者要么没有结石,要么只有少量(小于或等于3毫米)残留碎片。C组ESWL次数多,住院时间长,半酸素冲洗时间长。C组患者出院时无结石肾单位比例显著高于A组(p < 0.05), 4周后显著高于A组(p < 0.025)和B组(p < 0.05)。在6个月的随访中,C组92%的患者没有结石或只有少量(小于或等于3mm)残留碎片。低能体外冲击波碎石联合半酸苷灌洗可成功治疗感染非常大的鹿角结石。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Minimally invasive treatment of hemiacidrin soluble staghorn renal stones.

Among 78 patients with hemiacidrin soluble staghorn renal stones, 23 were treated with a combination of one session of percutaneous debulking and high-energy extracorporeal shock wave lithotripsy (ESWL) (Group A); 17 were treated with high-energy ESWL only (Group B); and 38 were treated with low-energy only ESWL (Group C). In all patients percutaneous nephrostomies were inserted and the ESWL procedure was followed by hemiacidrin irrigation. ESWL was performed with anesthesia in Groups A and B, but without anesthesia in Group C. Groups A and B did not differ in number of ESWL sessions or length of hospital stay, and the therapeutic results at discharge and at 6-month follow-up were comparable, whereby 59% of the patients in both groups were either stone-free or had only small ( less than or equal to 3 mm) residual fragments. In Group C more ESWL sessions were performed, and the hospital stay as well as the hemiacidrin irrigation periods were longer. The fraction of stone-free renal units at discharge was significantly higher in Group C than in Group A (p less than 0.05) and after 4 weeks higher than in both Groups A (p less than 0.025) and B (p < 0.05). At 6 month follow-up, 92% of the patients in Group C were either stone-free or had only small ( less than or equal to 3 mm) residual fragments. Combined low-energy ESWL and hemiacidrin irrigation can successfully be used for treatment of even very large infection staghorn stones.

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