过度充盈膀胱在1163例肾结石ESWL治疗中的应用

Application of excessive full urinary bladder in extracorporeal shock wave lithotripsy in 1163 cases of renal calculi

目的探讨膀胱过度充盈在肾结石体外冲击波碎石治疗中的作用。方法B超定位体外冲击波碎石治疗单纯性肾结石1 163例:常规治疗102例(126侧),辅以利尿憋尿法使膀胱过度充盈从而充盈肾集合系统治疗1 061例(1 247侧)。结果常规方法治疗组和辅以利尿憋尿方法治疗组的一次碎石成功率分别是61.9%和93.7%,2个月残石率分别是8.7%和1.8%,组间差异有统计学意义(P<0.05)。结论B超定位体外冲击波碎石治疗无肾积水的肾结石时,辅以利尿憋尿的方法使膀胱过度充盈并充盈肾集合系统,具有易于观察、碎石率高、排石时间短、结石排净率高和并发症少而轻微的优点。

Objective To study the role of excessive full urinary bladder in the extracorporeal shock wave lithotripsy（ESWL） for treating renal calculi. Methods 1 163 cases of pure renal calculi were treated by B-mode ultrasonic locating ESWL：102 cases（1 126 sides） of conventional methods, 1 061 cases（1 1247 sides） of conventional methods assisted with diureses and holding back urine to cause the urinary bladder to full excessively for filling the kidney collecting system. Results The successful rates at one lithotripsy of the conventional methods treatment group and treatment group of conventional methods assisted with diureses and holding back urine were 61.9% and 93.7%respectively. The two-months residual calculi rates of two groups were 8. 7% and 1.8%respectively, with statistical significance（P〈0.05）. Conclusion The B-mode ultrasonic locating ESWL assisted with diureses and holding back urine to cause the urinary bladder to full excessively and fill the kidney collecting system for treating renal calculi without hydronephrosis, has the advantages,such as easily observing the patientrs condition, high comminution rate of calculi,short discharging calculi time,high stone-free rate and no serious side effects.