Changes of serum β2-MG, Cys C and urine mAlb levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy and their clinical significance

Objective:To investigate the changes of serumβ2 microglobulin(β2-MG),cystatin C(CysC)and urine microalbumin(mAlb)levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy and their clinical significance.Methods Sixty-eight patients with ureteral calculi admitted to the hospital between June 2018 and June 2019 were selected as the observation group.35 volunteers who received physical elimination in the hospital during the same period were selected as the control group.Levels ofβ2-MG,Cys C and urine mAlb in the observation group were compared before and after treatment,and compared with those in the control group.Changes in serumβ2-MG,Cys C and urine mAlb levels and renal function indicators[blood urea nitrogen(BUN),serum creatinine(SCr)]in patients with different prognosis in the observation group after treatment were analyzed.The value of serumβ2-MG,Cys C and urine mAlb levels in the diagnosis and treatment of ureteral calculi was analyzed with ROC curve.The correlations between serumβ2-MG,Cys C and urine mAlb levels and renal function indexes were analyzed.Results Serumβ2-MG,Cys C and urine mAlb levels in the observation group before treatment were significantly higher than those in the same group after treatment or those in the control group(P<0.05).Serumβ2-MG,Cys C and urine mAlb levels,BUN and SCr in patients with residual stones were significantly higher than those in patients without(P<0.05).ROC curve analysis showed that the sensitivity and the area under the curve of combined detection of serumβ2-MG,Cys C and urine mAlb levels for evaluating the curative effect of extracorporeal shock wave lithotripsy on ureteral calculi were significantly higher/larger than those of single detection of the three(P<0.05).Partial correlation analysis showed that serumβ2-MG,Cys C and urine mAlb levels were positively correlated with BUN and SCr(P<0.05).Conclusion There are obvious changes of serumβ2-MG,Cys C and urine mAlb levels in patients with ureteral calculi before and after extracorporeal shock wave lithotripsy.The combined detection of the three indexes is helpful for the early diagnosis of ureteral calculi and the evaluation of renal function after lithotripsy.They can provide reference for protecting renal function in patients with ureteral calculi treated by extracorporeal shock wave lithotripsy.

Epidural anesthesia is effective for extracorporeal shock wave lithotripsy of pancreatic and biliary calculi

AIM: To evaluate the efficacy of thoracic epidural analgesia for extracorporeal shock wave lithotripsy (ESWL). METHODS: ESWL is an effective, non-invasive technique for the treatment of difficult pancreatic and large bile duct calculi. The procedure is often painful and requires large doses of analgesics. Many different anesthetic techniques have been used. Patients with either large bile duct calculi or pancreatic duct calculi which could not be extracted by routine endoscopic methods were selected. Thoracic epidural anesthesia (TEA) was routinely used in all the subjects unless contraindicated. Bupivacaine 0.25% with or without clonidine was used to block the segments D6 to D12. The dose was calculated depending on the age, height and weight of the patient. It was usually 1-2 mL per segment blocked.RESULTS: Ninety eight percent of the 1509 patients underwent ESWL under TEA. The subjects selected were within American Society of Anesthesiologists grade Ⅰ to Ⅲ. ESWL using EA permitted successful elimination of bile duct or pancreatic calculi with minimal morbidity. The procedure time was shorter in patients with TEA than in those who underwent ESWL under total intravenous anesthesia. CONCLUSION: Almost all patients undergoing ESWL with EA had effective blocks with a single catheter insertion and local anesthetic injection.

Efficacy of Extracorporeal Shock Wave Lithotripsy (ESWL) versus Pneumatic Ureteroscopic Lithotripsy (URSL) for Lower Ureteral Stones Therapy in Asia: A Meta-Analysis

Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy or pneumatic ureteroscopic lithotripsy for lower ureteral stones therapy, we sought to identify and summarize randomized controlled trials that were used to treat distal ureteral stone. Methods: Eligible studies were identified from electronic databases. Database search, quality assessment, and data extraction were performed by two reviewers independently. Our primary outcome was the stone-free rate. Secondary outcomes were the fragmentation rate, complications and the rate of re-treatment and secondary procedures. The results were assessed by Review Manager 5.0. Publication bias was evaluated by Stata 11.0. Results: 13 trials were included. Meta-analysis of pooled data showed that pneumatic ureteroscopic lithotripsy demonstrated a significant advantage over extracorporeal shock wave lithotripsy (OR = 0.14, 95% CI [0.09, 0.23], P < 0.00001) in the stone-free rate;the extracorporeal shock wave lithotripsy had statistical disadvantages over pneumatic ureteroscopic lithotripsy in the fragmentation rate of ureteral stones (OR = 0.14, 95% CI [0.05, 0.39], P = 0.0002);and the rate of re-treatment and secondary procedure was lower in pneumatic ureteroscopic lithotripsy than in extracorporeal shock wave lithotripsy (OR = 5.37, 95% CI [2.61, 11.07], P < 0.00001). Our pooled results showed that there was no statistical difference between extracorporeal shock wave lithotripsy and pneumatic ureteroscopic lithotripsy in hematuresis, ureteral stricture and urosepsis or fever. Finally extracorporeal shock wave lithotripsy had a higher incidence of colic pain than pneumatic ureteroscopic lithotripsy. Conclusion: The present meta-analysis suggested that pneumatic ureteroscopic lithotripsy had large advantages over extracorporeal shock wave lithotripsy in the treatment of lower ureteral stones.

Extracorporeal Shock Wave Lithotripsy Treatment for Renal and Ureteral Stones in Duhok City

The present study reports the results of extracorporeal shock-wave lithotripsy treatment for renal and ureteral stones in Duhok city. The data were collected from the center of breakdown kidney stones in Duhok hospital. There were a total of 40 patients (25 males and 15 females) aged from 20 to 60 years old. The patients harboring (23 renal and 17 ureteral) stones of size ranged from 7.5 to 20 mm. Almost stones are of average size 9 mm and composed of uric acid, calcium and cystine stones. The study has been carried out by taking into consideration the parameters (type, sizes, composition and location of stone as well as region and ages of patients, also power, number of shock wave and sessions). The results show that the stones size increases according to increasing ages of patients (male and female) for uric acid ureter stone and calcium (renal, ureter) stones. Also (renal, ureter) stone size for patients aged from 20 to 30 years old increases from the minimum value for phosphate to maximum value for cystine stones, while for patients aged from 40 to 60 years old, the minimum size is obtained for calcium oxalate and the maximum size for calcium only. On the other hand, for uric acid stones of average size 9 mm, number of shock wave and sessions as well as the power required to breakdown the stones decrease nearly exponentially according to enhancing patients’ ages. At the same time, it's found that for adult patients (20 - 30 years old), number of sessions and the power of shock wave decrease also according to increasing size of calcium and cystine stones. Contrary to that, for the same ages and renal, uretral cysteine stones number of shock wave needed to breakdown large stones will be increased.

EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY FOR URINARY CALCULI: 18 YEARS EXPERIENCE

Objective To report our experience of extracorporeal shock wave lithotripsy （ESWL） for patients with urinary calculi. Methods From Jun. 1987 to Dec. 2005, a total of 10100 patients with urinary calculi in the kidney or ureter accepted ESWL. The kidney stones were sorted by FDA standard. The ureteric stone was sorted by its site and retrograde pyelography. At the same time, we summarized the recurrence of kidney stone and its relationship between extracorporeal shock wave lithotripsy （ ESWL ） and hypertension. Results The efficacy for class I kidney stone was 91.2% that for class II 86. 5% and class III 72.3% , the healing rate for ureteric stone was 84. 5%. Combined retrograde pyelography and ESWL couM improve the efficacy. If ESWL failed, the ureteric stone could still be removed by operation or ureterscopy （ 1.1% ）. The rate of recurrence of kidney stone was 6. 1% and the incidence of hypertension post-treatment reached 7. 9%. Conclusion ESWL is a preferred approach to treat urinary calculi.

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

For over 35 years shock wave lithotripsy has proven to be an effective,safe and truly minimally invasive option for the treatment of nephrolithiasis.Various technical factors as well as patient selection can impact the success of the procedure.We used published work focusing on outcomes of shock wave lithotripsy,risk of complications,and strategies for improving stone fragmentation to create this review.Multiple patient and technical factors have been found to impact success of treatment.Skin to stone distance,stone density and composition,size and location of the stone within the urinary system all influence stone free rates.A slower rate with a gradual increasing voltage,precise targeting,proper coupling will improve stone fragmentation and decrease risk of complications.The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.

Extracorporeal Shock Wave Lithotripsy in the Treatment of Single Ureteric Stone. Initial Data from Iraq

Background: Extracorporeal shock wave lithotripsy (ESWL) became the first line in the treatment of ureteric stone after failure of conservative treatment because of its safety, simplicity and effectiveness. It is not invasive procedure and can be done on outpatient basis without anesthesia and with few complications which is most probably temporary and treatable. The objective of this study is to evaluate the efficiency and safety of ESWL in treatment of ureteric stone in Iraq. Materials and Methods: A total of 112 Iraqi patients with ureteric stones were participated in this prospective observational study in which patients scheduled for ESWL treatment for a period of 6 months. Patients were divided into 2 groups: 1) Group 1: 52 patients with proximal ureteric stone;2) Group 2: including 60 patients with distal ureteric stone. Preoperatively all patient underwent bowel preparation and were asked to fast for 8 hours before the procedure. Results: The age ranged between 22 and 55 with mean of 42 (SD = 5) years. Around 46% had proximal ureteric stone and the rest were in distal ureter. Around 44% needed one session and 40% needed two sessions to be stone-free respectively. In regards to associated symptoms, 74% had ureteric colic, 3% haematuria, 43% microhematuria and 12% UTI. Mild hydronephrosis was found in 90% of the cases and 30 reported had previous intervention. Success rate was 90%. Conclusions: ESWL is safe and effective in treatment of ureteric stone with few complications and must be regarded first choice after conservative treatment in a patient with uncomplicated ureteric stone.

清热活血排石汤结合体外冲击波碎石术对输尿管结石患者中医证候积分的影响

目的 探究清热活血排石汤结合体外冲击波碎石术对输尿管结石患者中医证候积分的影响。方法 回顾性选取2021年1月—2023年12月松原市中心医院收治的98例输尿管结石患者的临床资料,以不同治疗方法分为对照组、研究组,各49例,两组均应用体外冲击波碎石术治疗,在此基础上,术后对照组应用常规药物治疗,研究组在对照组基础上应用清热活血排石汤,比较两组治疗效果、中医证候积分、肾功能指标(血肌酐、尿素氮)、排石情况(开始排石时间、排石周期)及不良反应发生率。结果 研究组治疗总有效率为97.96%(48/49),高于对照组的83.67%(41/49),差异有统计学意义(χ^(2)=4.404,P<0.05)。治疗前两组中医证候积分、血肌酐、尿素氮比较,差异无统计学意义(P均>0.05);治疗后,研究组中医证候积分、血肌酐、尿素氮均低于对照组,差异有统计学意义(P均<0.05)。研究组开始排石时间、排石周期均短于对照组,差异有统计学意义(P均<0.05)。研究组结石清除率高于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 在输尿管结石患者体外冲击波碎石术及常规药物治疗基础上,联合应用清热活血排石汤,可提升治疗效果,降低中医证候积分,减轻肾功能损伤,提升结石清除率,且安全性良好。

四金排石汤联合耳穴压豆在行体外冲击波碎石术后的输尿管结石中的应用

目的观察四金排石汤联合耳穴压豆治疗行体外冲击波碎石术(ESWL)后的输尿管结石的临床效果。方法选取70例行ESWL后的输尿管结石患者,根据治疗方案分为观察组和对照组,各35例。所有患者均接受ESWL治疗,术后观察组给予四金排石汤联合耳穴压豆治疗,对照组行常规排石治疗,比较两组临床效果、排石效果以及并发症发生情况。结果观察组临床疗效为91.43%(32/35),明显高于对照组的60.00%(21/35)(P<0.05)。观察组临床并发症发生率为34.29%(12/35),明显低于对照组的71.43%(25/35)(P<0.05)。观察组患者当日排石率及术后1周、2周净石率均明显高于对照组(P<0.05)。结论四金排石汤联合耳穴压豆应用于行ESWL后的输尿管结石患者,可提高临床疗效、提高排石率、降低并发症,值得临床推广使用。

肾盏憩室结石腔内手术治疗单中心分析并文献复习

目的分析不同腔内手术治疗肾盏憩室患者的疗效,为提高此类疾病的诊治水平提供参考。方法回顾性分析广州医科大学附属第一医院2025年1月—2021年12月收治的21例肾盏憩室结石患者的临床资料。依据手术方法将患者分为经尿道输尿管软镜手术组(RIRS组,n=14)和经皮肾镜手术组(PCNL组,n=7),并进行组间数据分析。结果RIRS组和PCNL组结石最大径分别为(11.56±4.79)mm和(13.06±6.27)mm,差异无统计学意义(P=0.609)。RIRS组与PCNL组在憩室顶肾实质厚度[(10.08±4.81)mm vs.(5.24±2.23)mm,P=0.005]、手术时间[(58.57±19.23)min vs.(88.29±25.28)min,P=0.007]、住院时间[3(1,5)d vs.11(5,12)d,P=0.023]方面比较差异有统计学意义。而两组术后结石清除率、血红蛋白下降值、术后并发症情况比较差异无统计学意义(P>0.05)。结论对于肾盏憩室结石,RIRS和PCNL都是可供选择的手术方式,RIRS的手术时间和住院时间更短,PCNL可在RIRS手术失败时作为替代手术方式。

重复体外冲击波碎石治疗上尿路结石患者疗效预测模型的建立与验证

目的分析重复体外冲击波碎石(ESWL)治疗上尿路结石(UUC)效果的独立影响因素,并根据独立影响因素构建重复ESWL治疗UUC疗效的列线图模型。方法回顾性收集2020年1月—2022年12月十堰市人民医院接受重复ESWL治疗的203例UUC患者的临床资料,按照治疗效果分为成功组(117例)和失败组(86例),比较两组患者的一般资料:年龄、性别;结石特征:结石体积(SV)、结石表面积(SA)、皮肤至结石距离(SSD)、结石最大CT值、平均结石密度(MSD)、结石异质性指数(SHI)等。采用logistic回归分析重复ESWL治疗UUC的独立预测因素,纳入有意义的变量(P<0.05)建立列线图。采用受试者工作特征(ROC)曲线和递减曲线分析(DCA)评价模型的效能,并进行内部验证。结果逐步回归显示,SV、SSD、MSD、SHI是重复ESWL治疗UUC的独立影响因素(P<0.05)。ROC曲线下面积(AUC)=0.793,95%CI:0.674~0.911;当最佳阈值为0.619时,其敏感度为77.1%,特异度为74.0%。DCA曲线在两条极端曲线之上。Hosmer-Lemeshow拟合优度检验显示,模型具有较好的校准度(χ^(2)=5.526,P=0.489),矫正C指数为0.746。结论SV、SSD、MSD、SHI是重复ESWL治疗UUC的独立预测因素,由上述指标建立的模型具有较好的预测效能。

坦索罗辛在体外冲击波碎石术后的应用效果分析

目的:分析坦索罗辛在体外冲击波碎石术后的应用效果。方法:选取2022年1月—2023年6月北京市大兴区中西医结合医院收治的输尿管结石患者156例作为研究对象,依据随机数字表法分为对照组、观察组,各78例。所有患者接受体外冲击波碎石术治疗,对照组手术后接受常规治疗,观察组在对照组基础上应用坦索罗辛治疗。比较两组治疗效果。结果:观察组术后2周排石成功率高于对照组,结石排净时间短于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P=0.031)。术后,观察组血清白细胞介素-6、C反应蛋白水平低于对照组,差异有统计学意义(P<0.05)。结论:坦索罗辛在体外冲击波碎石术后的应用有助于提高排石成功率,缩短结石排净时间,降低炎性因子水平,术后并发症发生率低。

血清β2-MG、ACTH及降钙素原水平预测肾结石患者ESWL术后肾损伤的价值

目的探讨血清β2微球蛋白(β2-MG)、促肾上腺皮质激素(ACTH)及降钙素原水平预测肾结石患者体外冲击波碎石术(ESWL)后肾损伤的价值。方法前瞻性选取2021年6月至2023年6月青岛市第五人民医院收治的100例肾结石患者作为研究对象。患者均行ESWL,对患者进行术后7 d随访,根据是否发生肾损伤分为发生组(n=8)与未发生组(n=92)。收集患者基线资料,包括性别、年龄、体重指数、肾损伤史、吸烟、饮酒、结石直径、结石位置、结石数量、手术时间,检测实验室指标(甘油三酯、总胆固醇、β2-MG、ATCH、皮质醇、降钙素原)。比较两组基线资料及实验室指标;采用非条件Logistic逐步回归分析肾结石患者ESWL术后发生肾损伤的危险因素;通过受试者操作特征(ROC)曲线分析β2-MG、ACTH、皮质醇、降钙素原预测肾结石患者ESWL术后肾损伤的价值。结果两组性别构成比、年龄、体重指数、肾损伤史、吸烟、饮酒、结石直径、结石位置、结石数量、手术时间、甘油三酯、总胆固醇组间比较,差异均无统计学意义(P>0.05);发生组β2-MG、ACTH、皮质醇、降钙素原水平分别为(3.45±0.89)mg/L、(36.29±6.08)ng/L、(139.06±19.74)μg/L、(2.92±0.95)ng/mL,均显著高于未发生组[(2.31±0.72)mg/L、(26.71±5.02)ng/L、(121.15±16.93)μg/L、(1.48±0.41)ng/mL],差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,β2-MG、ACTH、皮质醇、降钙素原是肾结石患者ESWL术后发生肾损伤的危险因素(P<0.05)。ROC曲线分析结果显示,β2-MG、ACTH、皮质醇、降钙素原预测肾结石患者ESWL术后肾损伤发生的曲线下面积分别为0.819、0.933、0.834、0.838,敏感度分别为0.875、0.875、0.750、0.750,且P<0.05。结论肾结石ESWL术后发生肾损伤的患者β2-MG、ACTH、皮质醇、降钙素原水平显著上升,以上指标可用于预测肾结石患者ESWL术后发生肾损伤。

健脾祛湿膏联合体外冲击波碎石治疗输尿管结石肥胖患者的效果

目的:探究健脾祛湿膏联合体外冲击波碎石治疗输尿管结石肥胖患者的效果。方法:选择2021年3—10月广州市中西医结合医院外科收治的58例输尿管结石肥胖患者为研究对象,随机分成对照组和观察组,各29例。其中,对照组采用体外冲击波碎石治疗,观察组采用健脾祛湿膏联合体外冲击波碎石治疗。比较两组并发症发生率、围手术期指标、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿α_(1)-微球蛋白(α_(1)-MG)水平及视觉模拟评分法(VAS)评分。结果:两组各项并发症发生率比较,差异无统计学意义(P>0.05)。观察组住院天数、操作时间明显短于对照组,出血量明显少于对照组,差异有统计学意义(P<0.05)。术前,两组NGAL、α_(1)-MG水平比较,差异无统计学意义(P>0.05);术后7 d,观察组NGAL、α_(1)-MG水平明显低于对照组,差异有统计学意义(P<0.05)。术前,两组VAS评分比较,差异无统计学意义(P>0.05);术后7 d,观察组VAS评分明显低于对照组,差异有统计学意义(P<0.05)。结论:健脾祛湿膏联合体外冲击波碎石治疗肥胖症输尿管结石患者效果显著,可减少出血量,缓解患者疼痛程度,提高治疗效果,改善患者生活质量。

消瘀化石汤联合体外冲击波碎石术对输尿管结石患者结石排出和血清炎症因子的影响

目的 探讨消瘀化石汤联合体外冲击波碎石术对输尿管结石患者结石排出和血清炎症因子的影响。方法 回顾性分析80例输尿管结石患者的临床资料,将实施单纯体外冲击波碎石术治疗的40例分为对照组,实施消瘀化石汤+体外冲击波碎石术治疗的40例分为观察组。治疗14 d并完成6个月随访。比较两组临床疗效、中医证候积分、治疗前后血清炎症因子[C反应蛋白(C-reactive protein, CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及白细胞介素-6(interleukin-6,IL-6)]及肾功能[血肌酐(serum creatinine, Scr)、微量白蛋白(microalbumin, mALB)及β2微球蛋白(β2-microglobulin, β2-MG)]的变化,并记录治疗期间并发症情况;随访6个月,比较两组复发情况。结果 观察组临床总有效率高于对照组(P<0.05)。治疗后,两组中医证候积分各维度分值均降低(P<0.05),且观察组更低(P<0.05)。治疗后,两组CRP、TNF-α及IL-6均降低(P<0.05),且观察组更低(P<0.05)。治疗后,两组Scr、mALB及β2-MG均下降(P<0.05),且观察组更低(P<0.05)。两组总并发症发生率及复发率无显著差异(P>0.05)。结论 对输尿管结石患者实施消瘀化石汤联合体外冲击波碎石术排石效果显著,将降低患者中医证候积分及血清炎症因子水平,改善患者肾功能,且未增加不良反应发生率。

体外冲击波碎石术治疗输尿管结石患者碎石失败的影响因素

目的:分析体外冲击波碎石术(ESWL)治疗输尿管结石患者碎石失败的影响因素。方法:选取2020年3月至2023年2月该院收治的200例输尿管结石患者进行横断面研究。所有患者均行ESWL治疗,统计患者碎石效果,采用Logistic回归分析ESWL治疗输尿管结石患者碎石失败的影响因素。结果:200例输尿管结石患者中碎石失败43例,占21.50%(43/200),设为失败组;碎石成功157例,占78.50%(157/200),设为成功组。两组性别、年龄、体质量指数(BMI)、合并糖尿病、伴血尿、伴肾积水、患侧、术中出血量等比较,差异均无统计学意义(P>0.05);失败组病程、结石直径、结石嵌顿、结石位置、结石数量、结石成分与成功组比较,差异均有统计学意义(P<0.05);经Logistic回归分析结果显示,病程长、结石直径大、结石嵌顿、输尿管中段结石、结石数量>3个、草酸钙结石均是ESWL治疗输尿管结石患者碎石失败的危险因素(OR>1,P<0.05)。结论:病程长、结石直径大、结石嵌顿、输尿管中段结石、结石数量>3个、草酸钙结石等均为影响ESWL治疗输尿管结石患者碎石失败的危险因素。

宁泌泰胶囊对输尿管结石患者ESWL术后排石率及疼痛程度的影响

目的探讨宁泌泰胶囊对输尿管结石患者体外冲击波碎石术(ESWL)术后排石率及疼痛程度的影响。方法选取萍乡市第三人民医院2021年1月至2022年12月收治的输尿管结石患者95例,以抽签法分为对照组(48例)、研究组(47例)。两组均行ESWL治疗,对照组术后予常规治疗,研究组基于常规治疗予宁泌泰胶囊治疗;对比两组排石率,症状消退时间,疼痛程度,血清炎性因子水平及不良反应。结果研究组排石率(74.47%)较对照组(58.33%)高,但组间比较差异无统计学意义(P>0.05);研究组血尿消失、腰痛减轻时间较对照组短,差异有统计学意义(P<0.05);研究组术后1周视觉模拟法(VAS)评分、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)水平较对照组低,差异有统计学意义(P<0.05);组间不良反应发生率对比,差异无统计学意义(P>0.05)。结论宁泌泰胶囊治疗输尿管结石患者可提高ESWL术后排石率,促使症状消退,降低疼痛程度,减轻炎症损伤,且安全性好。

输尿管结石ESWL术后应用穴位灸法联合耳穴压豆的效果分析

目的:探讨输尿管结石体外冲击波碎石术(ESWL)后患者采用穴位灸法联合耳穴压豆的效果。方法:按照随机数表法将医院收治的80例输尿管结石患者分为两组,各40例患者。两组患者均行ESWL,对照组患者术后实施常规护理,基于此,观察组患者加用穴位灸法联合耳穴压豆,均干预7d。比较两组术后疼痛程度、恢复情况、护理满意度及并发症。结果:观察组肉眼血尿消失时间、腰痛缓解时间、结石排净时间均比对照组短(P<0.05);观察组患者术后6h、12h及术后1d、3d、7d时的VAS评分均低于对照组,差异有统计学意义(P<0.05);观察组患者并发症发生率低于对照组(P<0.05);观察组患者护理满意度高于对照组(P<0.05)。结论:穴位灸法联合耳穴压豆可减轻输尿管结石患者ESWL术后的疼痛程度,减少并发症发生,促进患者术后恢复,提高护理满意度。

体外冲击波与输尿管镜钬激光碎石术治疗输尿管中上段结石的效果研究

目的 分析输尿管中上段结石给予输尿管镜钬激光碎石术和体外冲击波碎石治疗对于患者的影响。方法 方便选取2022年7月—2023年10月青岛市黄岛区中心医院收治的94例输尿管中上段结石患者为研究对象,根据不同治疗方法分组,各47例,对照组开展体外冲击波碎石术治疗,观察组开展输尿管镜钬激光碎石术治疗。比较两组患者的手术指标、术后并发症,治疗前后肾功能指标、肾积水程度以及炎症因子水平。结果 观察组一次性结石清除率为97.87%(46/47),高于对照组的82.98%(39/47),结石上移率为6.38%(3/47),低于对照组的25.53%(12/47),差异有统计学意义(χ^(2)=4.423、6.425,P均<0.05)。观察组住院时间短于对照组,差异有统计学意义(P<0.05)。两组手术时间比较,差异无统计学意义(P>0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。治疗前,两组的肾功能指标、肾积水程度及炎症因子水平相比,差异无统计学意义(P均>0.05);治疗后,观察组的肾功能指标、肾积水程度及炎症因子水平均优于对照组,差异有统计学意义(P均<0.05)。结论 输尿管镜钬激光碎石术疗法用于输尿管中上段结石的治疗中,能有效清除结石,并预防结石上移,改善患者肾积水和肾功能,可以降低术后并发症,纠正炎症反应。

体外冲击波碎石和经皮肾镜气压弹道碎石治疗泌尿结石的临床效果

目的:分析体外冲击波碎石和经皮肾镜气压弹道碎石治疗泌尿结石的临床效果。方法:选取2021年2月—2022年12月安庆秉风医院收治的100例泌尿结石患者作为研究对象,采用随机数字表法分为对照组和研究组,每组50例。对照组采用体外冲击波碎石手术,研究组采用经皮肾镜气压弹道碎石手术治疗。对比两组治疗效果、结石排净时间、住院时间、并发症发生率及治疗依从性。结果:研究组治疗总有效率、并发症总发生率、治疗总依从性高于对照组,结石排净时间、住院时间短于对照组(P<0.001)。结论:与体外冲击波碎石术相比,经皮肾镜手术治疗泌尿结石的临床效果显著,能够缩短结石排净时间和住院时间,提高患者治疗依从性,但并发症发生率较高。因此,临床需要根据患者的具体病情选择手术方法。