摘要
目的比较宽焦斑高能量与传统窄焦斑低能量体外冲击波碎石(SWL)治疗肾结石的疗效及安全性。方法将接受SWL治疗的肾结石患者分为两组,A组用宽焦斑高能量碎石机,B组用窄焦斑低能量碎石机。SWL前后分别检测尿嗜中性粒细胞明胶酶相关载脂蛋白(NGAL)和α1微球蛋白(α1-MG)。结果两组各60例入选,1个月结石排净率及并发症率差异均无显著性。结石>10 mm者,A组的复震率较低(11.1%vs 39.1%,P=0.021),但并发症率(25.9%vs 4.3%,P=0.038)较高。A组NGAL升高幅度显著高于B组(P<0.001)。结论宽焦斑高能量与窄焦斑低能量SWL均是肾结石的有效安全的治疗方法,对于10 mm以上的肾结石,前者带给结石更多的能量同时也造成了更多的一过性损伤。NGAL对评价SWL引起早期肾损伤有潜在作用。
Objective To compare the clinical efficacy and safety of wide-focus high energy lithotriptor with narrow-focus low energy lithotriptor treating renal calculi. Methods A prospective study was conducted to compare both modalities for the management of renal calculi. Stone formers were randomly enrolled into two groups. Group A was managed with wide-focus high energy lithotriptor, while group B was managed with the other. Urine samples were collected to detect neutrophil gelatinase-associated lipocalin (NGAL) and ct 1-microglobulin (a 1- MG) levels before and after SWL. Results 60 were randomized to the group A and 60 to group B. There was no significant difference between two groups in stone free rate and complication rate. For stones more than 10 mm, re- treat rate( 11.1% vs 39.1% ,P -- 0.021 ) was lower and complication rate (25.9% vs 4.3% ,P = 0.038) was higher in group A. There had a larger increase of NGAL in group A (P 〈 0.001 ) after SWL. Conclusion SWL with both lithotriptors are effective and safe for renal stones. Wide-focus high energy lithotripsy was assoeiated with lower retreat rate and higher complication rate for stones more than 10 ram. NGAL may play a potential role in the evaluation of SWL indueed early renal injury.
作者
章璟
徐冀东
杨佳伟
胡传义
张鹤
刘爽
王国增
姜宁
ZHANG Jing , XU Jidong , YANG Jiawei , HU Chuanyi , ZHANG He, LIU Shuang , WANG Guoz- eng, JIANG Ning.(Department of Urology, Shanghai Pudong New Area Gongli Hospital, Shanghai 200135, Chin)
出处
《实用医学杂志》
CAS
北大核心
2018年第5期774-777,共4页
The Journal of Practical Medicine
基金
上海市医学重点专科建设计划资助(编号:ZK2015A11)