探讨体外冲击波碎石治疗经皮肾镜术后残石的时机及对治疗安全性、结石清除率的影响因素

Study on Opportunity of Extracorporeal Shock Wave Lithotripsy in Treatment of Residual Stones after Percutaneous Nephrolithotomy and Effect on Treatment Safety and Stones Clearance Rate

目的探讨体外冲击波碎石治疗经皮肾镜术后残石的时机及对治疗安全性、结石清除率的影响因素。方法回顾性分析该院泌尿科在2013年1月—2017年4月期间收治的32例接受经皮肾镜术后存在残石的肾结石患者临床资料,术后经CT影像确定残石后,计算皮肤和残石的距离、残石的大小。术后2周行体外冲击波碎石术的17例为A组患者,术后4周行体外冲击波碎石术的15例为B组。观察两组患者的治疗效果、结石清除率,并就两组患者并发症发生情况展开分析。结果 A、B两组患者临床治疗总有效率均为100.00%,比较差异无统计学意义(P>0.05);B组结石清除率为100.00%、并发症发生率为5.88%,A组结石清除率为86.67%、并发症发生率为13.34%,两组比较差异有统计学意义(P<0.05)。结论针对经皮肾镜术后残石的肾结石患者可行体外冲击波碎石治疗,相较于术后2周操作来说,术后4周体外碎石的时机最好,且结石清除率、安全性也较高,值得推广。

Objective To study the opportunity of extracorporeal shock wave lithotripsy in treatment of Residual stones after percutaneous nephrolithotomy and effect on treatment safety and stones clearance rate.Methods 32 cases of renal stone patients after the percutaneous nephrolithotomy admitted and treated in our hospital from January 2013 to April 2017 were selected and the residual stones were determined by the CT images after surgery and the distance from skin to residual stone and size of residual stones were calculated,and the 17 cases of patients with extracorporeal shock wave lithotripsy in two weeks after surgery were the group A,while 15 cases of patients with extracorporeal shock wave lithotripsy after four-week surgery were the group B,and the treatment effect and stones clearance rate of the two groups were observed and the occurrence of complications was analyzed.Results The total clinical treatment effective rate in the group A and in the group B was respectively 100.00%and 100.00%,and there was no obvious difference(P>0.05),and the differences in the stone clearance rate and incidence rate of complications between the group B and the group A were statistically significant(100.00%,5.88%vs 86.67%,13.34%),and the differences were statistically significant(P<0.05).Conclusion The opportunity of extracorporeal shock wave lithotripsy in treatment of Residual stones after percutaneous nephrolithotomy is the best in four weeks after operation compared with that in two weeks after surgery,and the stone clearance rate and safety are also high,which is worth promotion.