枸橼酸氢钾钠防治经皮肾镜取石术后结石残留及复发的研究

Effect of potassium sodium hydrogen citrate therapy on stone recurrences and residual stones after percutaneous nephrolithotomy for renal calculi

目的评估枸橼酸氢钾钠对肾结石患者经皮肾镜取石术后残留结石的清除和预防结石复发的效果。方法选择154例因上尿路结石而行经皮肾镜取石术术后无结石残留或有结石残留的患者被纳入研究。根据结石清除情况将患者分为无残石组84例和有残石组70例,每组再随机分为治疗组和对照组。治疗组给予枸橼酸氢钾钠颗粒治疗,10 g/d,3次/d,疗程3个月;对照组不加用任何药物,饮食要求与治疗组相同,术后12个月比较治疗组和对照组结石复发率或结石生长情况。结果无残石组接受药物治疗的患者12个月后结石复发率显著低于对照组(8.33%vs 38.46%,P<0.05),有残石组中接受药物治疗的患者结石增大的比率显著低于对照组(10.71%vs 59.37%,P<0.05)。结论枸橼酸氢钾钠不仅显著降低经皮肾镜术后结石的复发率,而且抑制术后残留结石的生长。

Objective To evaluate the efficacy of potassium sodium hydrogen citrate on residual stone re- moval and prevention of stone recurrence after percutaneous nephrolithotomy（PCNL） for renal calculi. Methods One hundred and fifty-four patients with residual stones or without residual stones after PCNL were enrolled in this study. Patients without residual stones （ n = 84） or with residual stones （ n = 70） were randomly divided into the treat- ment group and the control group respectively. The treatment group was given orally potassium sodium hydrogen cit- rate granules 10 g per day, and the control group was not treated with any medication. The stone recurrence was com- pared between the two groups after a follow-up of 12 months. Results For patients without residual stones, the stone recmTence rate in the treatment group was significantly lower than that in the control group（8.33% vs 38.46%, P 〈 0. 05）. For patients with residual stones group, the stone growth rate in the treatment group was also significantly lower than that in the control group （ 10. 71% vs 59. 37 %, P 〈 0.05）. Conclusion Potassium sodium hydrogen cit- rate therapy can not only reduce the stone recurrence, but also inhibit the residual stone growth after PCNL.