ESWL和F-URS在不同体质量儿童肾结石病人中的应用

王君; 梁宇; 郑金一; 李海波; 王茂富; 董志强; 李松

doi:10.13898/j.cnki.issn.1000-2200.2022.07.016

ESWL和F-URS在不同体质量儿童肾结石病人中的应用

Application of ESWL and F-URS in pediatric nephrolithiasis patients with different body mass

摘要

摘要:
目的探讨体外冲击波碎石术(ESWL)与输尿管软镜碎石术(F-URS)在不同体质量儿童肾结石病人中的应用价值。
方法选取单发性儿童肾结石病人为研究对象, 根据结石大小、体质量指数(BMI)及个人意愿共纳入41例, 依据BMI分为超重组(BMI ≥24.0 kg/m²)20例和非超重组(BMI < 24.0 kg/m²)21例, 2组再根据治疗方式不同各分为ESWL组(采用ESWL治疗)和F-URS组(采用F-URS联合钬激光碎石术治疗)2个亚组。分别比较超重组和非超重组不同治疗方式亚组的术后常见并发症(术后一过性血尿、术后发热)、一次碎石成功率及术后置入双J管情况。
结果在非超重组中, ESWL组病人术后一过性血尿和术后发热发生率、置入双J管病人例数均低于F-URS组(P < 0.05), 2组一次碎石成功率差异均无统计学意义(P>0.05)。在超重组中, F-URS组病人一次碎石成功率高于ESWL组(P < 0.05), 2组术后一过性血尿和术后发热发生率、置入双J管病人例数差异均无统计学意义(P>0.05)。
结论在非超重儿童肾结石病人中, ESWL与F-URS治疗效果相似, 可根据病人情况或医院偏好选择。在超重儿童肾结石病人中, ESWL治疗效果下降, F-URS具有稳定的碎石效果, 更适合超重病人。

Abstract:
ObjectiveTo investigate the application value of extracorporeal shock wave lithotripsy(ESWL) and flexible ureteroscope(F-URS) lithotripsy in pediatric nephrolithiasis patients with different body mass.
MethodsA total of 41 cases with single pediatric nephrolithiasis were included according to stone size body mass index(BMI) and personal intention.According to BMI, the patients were divided into overweight group(BMI ≥24.0 kg/m², n=20) and non-overweight group(BMI < 24.0 kg/m², n=21).The patients in the two groups were further divided into two subgroups including ESWL group(treated with ESWL) and F-URS group(treated with F-URS combined with holmium laser lithotripsy) according to the treatment method.The common postoperative complications(transient hematuria and postoperative fever), the success rate of one-time lithotripsy and the placement of double-J catheter after operation were compared between subgroups with different treatment method in overweight group and non-overweight group, respectively.
ResultsIn the non-overweight group, the incidence of transient hematuria and postoperative fever, and the number of patients with double-J catheter in the ESWL group were lower than those in the F-URS group(P < 0.05), and there was no significant difference in the success rate of one-time lithotripsy between the two groups(P>0.05).In the overweight group, the success rate of one-time lithotripsy in the F-URS group was higher than that in the ESWL group(P < 0.05), and there was no significant difference in the incidence of transient hematuria and postoperative fever, and the number of patients with double-J catheter between the two groups(P>0.05).
ConclusionsIn non-overweight patient with pediatric nephrolithiasis, ESWL and F-URS have similar therapeutic effects, which can be selected according to the patient's condition or hospital preference.In overweight patient with pediatric nephrolithiasis, the treatment effect of ESWL decreases, while F-URS has a stable lithotripsy effect and is more suitable for overweight patient.

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