下极结石的尿路透镜与冲击波石术:手术协作中的治疗变化和结果
John Michael DiBianco1, Stephanie Daignault-Newton2,3, Golena Fernandez Moncaleano2
1Department of Urology, University of Florida, Gainesville, Florida.
The Journal of urology
|June 9, 2025
概括
冲击波石 (SWL) 在较低极 (LP) 石头中很常见,但尿道透视 (URS) 对于较小的石头,尽管并发症增加,但成功率更高. 这两种方法对较大的石头有效性有限,这表明需要改进治疗方法.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 腎石病的管理方法
- 最少侵入性的手术
背景情况:
- 目前的指导方针建议尿路透镜 (URS) 或冲击波石 (SWL) 用于下极 (LP) 的石头,直至1厘米.
- 对于尺寸为1-2厘米的LP石头来说,SWL是一种二线选择.
- 有限的数据存在于治疗模式的分布和结果在日益使用的URS的LP石头.
研究的目的:
- 为了评估用URS治疗的下极石的治疗分布,无石率 (SFR) 和未计划的医疗利用,与SWL对比.
- 根据石块大小 (≤1厘米和>1-2厘米) 来比较结果.
主要方法:
- 密歇根州泌尿外科改善协作注册表 (2016-2021) 的回顾性分析.
- 包括URS和SWL案例用于LP石 ≤2厘米.
- 统计分析以确定治疗模式预测因素,并比较SFR,急诊室访问和住院,调整为患者和实践因素.
主要成果:
- 对于2厘米以下的LP石头,SWL是占主导地位的模式 (62.7%).
- 在石头≤1厘米 (56%对39%) 中,URS实现了较高的SFR,但与急诊和住院病例的增加有关.
- 在URS和SWL之间的石头>1-2厘米时,没有观察到SFR的显著差异.
结论:
- 在密歇根州,SWL是LP石块≤2厘米的首选治疗方法.
- 虽然URS对较小的石头更有效,但它携带的发病率更高.
- 无论是URS还是SWL,对于较大的LP石头,都显示出低于最佳的疗效,这凸显了改善治疗策略的必要性.
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