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下尿道结石的医疗驱逐疗法的最佳持续时间:批判性评估
Erhan Erdoğan1, Gamze Şimşek2, Alper Aşık2
1Department of Urology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Research and Training Hospital, Istanbul, Turkey. erhandr@hotmail.com.
Urolithiasis
|March 23, 2024
概括
远端尿路结石的医疗驱逐疗法 (MET) 在前三周内最有效. 较长的治疗持续时间增加了风险和成本,但没有改善无石头率.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 药理学 药理学是指药理学的学科.
背景情况:
- 远端尿路结石是一个重大的临床挑战.
- 医疗驱逐疗法 (MET) 是一种常见的治疗方法.
- 对于远端尿路结石,MET的最佳持续时间需要进一步调查.
研究的目的:
- 为了确定远端尿路结石 (5-10毫米) 的MET的最佳持续时间.
- 评估治疗时间对无结石率和相关并发症的影响.
主要方法:
- 89名患有远端尿路结石的患者的前性研究.
- 在MET中涉及tamsulosin (0.4毫克) 和二甲 (75毫克).
- 患者每周评估4周使用KUB,超声波和NCCT,如果需要的话.
主要成果:
- 在第一周,无石头率为28.4%,第二周为28.4%,第三周为11.1%,第四周为8.6%.
- 19名 (23.5%) 患者在4周后仍然没有石头通过.
- 尿道壁厚度增加和水解与更长的石头通道时间相关.
- 在接受治疗超过3周的患者或没有经过结石的患者中,观察到更高的结节和急诊室访问率.
结论:
- 远端尿路结石 (5-10毫米) 的无结石率在MET的前3周内显著更高.
- 超过3周的延长MET提供了有限的好处,并增加了并发症和成本的风险.
- 对于那些在3周内没有达到无石头状态的患者,应考虑替代治疗选择.
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