枸橼酸氢钾钠对经皮肾镜取石术后临床无意义残留结石的影响

Effect of potassium sodium hydrogen citrate on clinically insignificant residual fragments after percutaneous nephrolithotomy

目的探讨枸橼酸氢钾钠对经皮肾镜取石术后临床无意义残留结石(CIRF)发展的干预作用。方法将60例因上尿路结石并行经皮肾镜取石术后确诊CIRF的患者纳入研究,随机分成干预组(31例)和对照组(29例)。两组均使用经皮肾镜取石术,干预组患者在术后给予枸橼酸氢钾钠10 g/d,疗程3个月;对照组未使用任何药物。比较两组术后临床症状的发生率以及结石的消失或生长情况变化。结果术后12个月,干预组和对照组残石增大发生率分别为12.90%和62.07%,残石消失发生率分别为41.94%和17.24%,残石减少或不变发生率分别为45.16%和20.69%,差异有统计学意义(P<0.05)。干预组和对照组术后残石相关肾绞痛的发生率分别为6.45%和31.03%,差异有统计学意义(P<0.05);肉眼血尿的发生率分别为25.81%和51.72%,差异有统计学意义(P<0.05)。结论枸橼酸氢钾钠对经皮肾镜取石术后CIRF发展起到明显的干预作用,可抑制CIRF生长,促进CIRF排出,减少CIRF引发的肾绞痛。

Objective To investigate the intervention effect of potassium sodium hydrogen citrate on the development of clinically insignificant residual fragments(CIRF)after percutaneous nephrolithotomy.Methods Sixty upper urinary calculus patients diagnosed with CIRF after percutaneous nephrolithotomy were included in this study and were randomly divided into intervention group(n=31 cases)and control group(n=29 cases).Percutaneous nephrolithotomy was performed in both groups.After the operation,the patients in the intervention group were given potassium sodium hydrogen citrate granules 10 g per day for 3 months,while the patients in the control group were not given any drugs.The incidence of clinical symptoms and the disappearance or growth of stones were compared between the two groups.Results At twelve months after the operation,the incidence of residual stone increase in volume was 12.90%in the intervention group and 62.07%in the control group,and the incidence of residual stone disappearance was 41.94%and 17.24%respectively,and the incidence of residual stone decreased or unchanged was 45.16%and 20.69%respectively,with significant differences between the two groups(P<0.05).The incidence of residual stone related renal colic was 6.45%in the intervention group and 31.03%in the control group,with a significant difference between the two groups(P<0.05).The incidence of gross hematuria was 25.81%in the intervention group and 51.72%in the control group,with a significant difference between the two groups(P<0.05).Conclusion Potassium sodium hydrogen citrate can significantly interfere with the development of stones in patients with CIRF after percutaneous nephrolithotomy,inhibit the growth of CIRF,promote the discharge of CIRF,and reduce the renal colic caused by CIRF.