Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurre...Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their effciency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guide-lines are useful in promoting public health and deve-loping nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient’s nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing litho-genic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.展开更多
Introduction: One of the most common disorders of the urinary tract is Urolithiasis. Twenty percent of lithiasis are located in the ureter of which 68% are seen in the distal ureter. The concept of medical expulsive t...Introduction: One of the most common disorders of the urinary tract is Urolithiasis. Twenty percent of lithiasis are located in the ureter of which 68% are seen in the distal ureter. The concept of medical expulsive therapy (MET) has been developed with enough knowledge of the ureter physiology in order to make easier the spontaneous expulsion of the stone. The aim of this study was to evaluate the efficacy and safety of three different drugs for the treatment of pelvic ureteral stones. Materiel and Methods: Between October 2017 and November 2018, 90 adult patients presenting with low or non-obstructive pelvic ureteral stones sized 8 to 10 mm were included. They were prospectively randomized, using computer-based randomization charts, into three equal groups: treatment with ketoprofen 100 mg once daily (Group I), silodosin 8 mg once daily (Group II) and tadalafil 5 mg once daily (Group III). The aim was to compare spontaneous expulsion of stone between those drugs Results: The mean expulsion time from the start of MET was 11.5 ± 3.27 days for ketoprofen group, 10.71 ± 3.98 days for silodosin group and 10.57 ± 3.40 days for tadalafil group. But these differences were also not significant (P = 0.79). The use of analgesics (grade II) was higher in groups II and III compared to group I, but without significant difference (23.33% in group I, 33.33% in group II and 40% in group III, p = 0.38). Discussion: The overall chance of spontaneous passage is low when the stone diameter is sized more than 7 mm. A wide range of spontaneous passage rates have been reported in the literature, varying from 71% to 98% for distal ureteral stones less than 5 mm and 25% - 53% for stone sized 5 to 10 mm with a mean expulsion time of more than 10 days. Conclusion: The three drugs have a low expulsion rate for 8, 9 and 10 mm pelvic ureteral stones with a higher adverse event rate for the NSAID group.展开更多
目的:分析腹腔镜与内镜联合治疗对胆囊结石伴胆管结石患者的影响。方法:选取2022年5月—2023年5月贵州医科大学附属白云医院收治的70例胆囊结石伴胆管结石患者作为研究对象。根据随机数表法将其分为对照组和观察组,各35例。对照组给予...目的:分析腹腔镜与内镜联合治疗对胆囊结石伴胆管结石患者的影响。方法:选取2022年5月—2023年5月贵州医科大学附属白云医院收治的70例胆囊结石伴胆管结石患者作为研究对象。根据随机数表法将其分为对照组和观察组,各35例。对照组给予传统手术治疗,观察组给予腹腔镜与内镜联合治疗。比较两组术前、术后3 d疼痛情况及生活质量,围手术期指标及术后并发症。结果:术后3 d,观察组视觉模拟评分法(visual analogue scale,VAS)评分低于对照组,简明生活质量量表(the MOS item short form 36 health survey,SF-36)评分高于对照组,差异有统计学意义(P<0.05)。观察组术中出血量少于对照组,术后首次排气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜与内镜联合治疗胆囊结石伴胆管结石的效果显著,具有疼痛轻、术中出血量少、术后恢复快等优点,从而能提升患者生活质量。展开更多
The prevalence of nephrolithiasis is increasing worldwide.Understanding and implementing medical therapies for kidney stone prevention are critical to prevent recurrences and decrease the economic burden of this condi...The prevalence of nephrolithiasis is increasing worldwide.Understanding and implementing medical therapies for kidney stone prevention are critical to prevent recurrences and decrease the economic burden of this condition.Dietary and pharmacologic therapies require understanding on the part of the patient and the prescribing practitioner in order to promote compliance.Insights into occupational exposures and antibiotic use may help uncover individual risk factors.Follow-up is essential to assess response to treatment and to modify treatment plans to maximize therapeutic benefit.展开更多
文摘Nephrolithiasis is a serious problem for both patients and the health system. Recurrence stands out as a significant problem in urinary system stone disease, the prevalence of which is increasing gradually. If recurrence is not prevented, patients may go through recurrent operations due to nephrolithiasis. While classical therapeutic options are available for all stone types, the number of randomized controlled studies and extensive meta-analyses focusing on their effciency are inadequate. Various alternative therapeutic options to these medical therapies also stand out in recent years. The etiology of urolithiasis is multifactorial and not always related to nutritional factors. Nutrition therapy seems to be useful, either along with pharmacological therapy or as a monotherapy. General nutrition guide-lines are useful in promoting public health and deve-loping nutrition plans that reduce the risk or attenuate the effects of diseases affected by nutrition. Nutrition therapy involves the evaluation of a patient’s nutritional state and intake, the diagnosis of nutrition risk factors, and the organization and application of a nutrition program. The main target is the reduction or prevention of calculus formation and growth via decreasing litho-genic risk factors and increasing lithogenic inhibitors in urine. This review focuses briefly on classical medical therapy, along with alternative options, related diets, and medical expulsive therapy.
文摘Introduction: One of the most common disorders of the urinary tract is Urolithiasis. Twenty percent of lithiasis are located in the ureter of which 68% are seen in the distal ureter. The concept of medical expulsive therapy (MET) has been developed with enough knowledge of the ureter physiology in order to make easier the spontaneous expulsion of the stone. The aim of this study was to evaluate the efficacy and safety of three different drugs for the treatment of pelvic ureteral stones. Materiel and Methods: Between October 2017 and November 2018, 90 adult patients presenting with low or non-obstructive pelvic ureteral stones sized 8 to 10 mm were included. They were prospectively randomized, using computer-based randomization charts, into three equal groups: treatment with ketoprofen 100 mg once daily (Group I), silodosin 8 mg once daily (Group II) and tadalafil 5 mg once daily (Group III). The aim was to compare spontaneous expulsion of stone between those drugs Results: The mean expulsion time from the start of MET was 11.5 ± 3.27 days for ketoprofen group, 10.71 ± 3.98 days for silodosin group and 10.57 ± 3.40 days for tadalafil group. But these differences were also not significant (P = 0.79). The use of analgesics (grade II) was higher in groups II and III compared to group I, but without significant difference (23.33% in group I, 33.33% in group II and 40% in group III, p = 0.38). Discussion: The overall chance of spontaneous passage is low when the stone diameter is sized more than 7 mm. A wide range of spontaneous passage rates have been reported in the literature, varying from 71% to 98% for distal ureteral stones less than 5 mm and 25% - 53% for stone sized 5 to 10 mm with a mean expulsion time of more than 10 days. Conclusion: The three drugs have a low expulsion rate for 8, 9 and 10 mm pelvic ureteral stones with a higher adverse event rate for the NSAID group.
文摘目的:分析腹腔镜与内镜联合治疗对胆囊结石伴胆管结石患者的影响。方法:选取2022年5月—2023年5月贵州医科大学附属白云医院收治的70例胆囊结石伴胆管结石患者作为研究对象。根据随机数表法将其分为对照组和观察组,各35例。对照组给予传统手术治疗,观察组给予腹腔镜与内镜联合治疗。比较两组术前、术后3 d疼痛情况及生活质量,围手术期指标及术后并发症。结果:术后3 d,观察组视觉模拟评分法(visual analogue scale,VAS)评分低于对照组,简明生活质量量表(the MOS item short form 36 health survey,SF-36)评分高于对照组,差异有统计学意义(P<0.05)。观察组术中出血量少于对照组,术后首次排气时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:腹腔镜与内镜联合治疗胆囊结石伴胆管结石的效果显著,具有疼痛轻、术中出血量少、术后恢复快等优点,从而能提升患者生活质量。
文摘The prevalence of nephrolithiasis is increasing worldwide.Understanding and implementing medical therapies for kidney stone prevention are critical to prevent recurrences and decrease the economic burden of this condition.Dietary and pharmacologic therapies require understanding on the part of the patient and the prescribing practitioner in order to promote compliance.Insights into occupational exposures and antibiotic use may help uncover individual risk factors.Follow-up is essential to assess response to treatment and to modify treatment plans to maximize therapeutic benefit.
