尿路透镜与冲击波石治疗治疗儿童和青少年的结石:非随机临床试验
Gregory E Tasian1,2, David I Chu3, Caleb P Nelson4
1Division of Urology, Department of Surgery, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
JAMA network open
|August 7, 2025
概括
尿路透镜和冲击波石显示儿童的石头清除情况类似. 冲击波石术提供了更好的患者结果,质疑了儿童结石治疗中对尿路透镜的普遍偏好.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 腎臟病學 (nephrology) 是一種醫學專業.
- 外科手术的结果
背景情况:
- 尿路透镜是儿科脏和尿道结石的主要治疗方法.
- 尿道显微镜与冲击波石术的指导建议不是最终的.
- 在儿科患者群体中比较这些治疗方法的证据有限.
研究的目的:
- 为了在儿童和青少年中比较尿路透镜和冲击波石术之间的石头清除率.
- 评估患者报告的结果,包括每次手术后的疼痛和功能恢复.
- 为临床实践提供有关儿科尿病最佳治疗策略的信息.
主要方法:
- 一项非随机临床试验,涉及31个医疗中心的1142名患者 (8-21岁).
- 患者接受了尿路透镜检查或冲击波石治疗,以检查脏或尿路结石.
- 主要结局是手术后6周通过超声波评估的石头清除.
主要成果:
- 尿道透镜 (71.2%) 和冲击波石 (67.5%) 之间的石头清除没有统计学上显著的差异.
- 尿路透镜与手术后一周明显增加的疼痛干扰和尿路症状有关.
- 经过尿路透镜检查的患者错过了更多的学校,照顾者错过了更多的工作,而这与冲击波石化术相比.
结论:
- 尿路透镜和冲击波石术在儿科患者的石头清除中表现出相似的疗效.
- 冲击波石与患者报告的优异结果和更快地恢复日常活动有关.
- 这些发现挑战了目前对尿路透镜的偏好,表明冲击波石作为一个可行的替代方案.
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