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目的:评估输尿管软镜碎石术(RIRS)术后肾下盏残余结石使用体外物理振动排石机治疗的有效性和安全性。方法:采用前瞻性随机对照研究,将所有符合入组标准的尿路结石患者随机分为体外物理振动排石组和自然排石组。体外物理振动排石组在RIRS术后给予物理振动排石机(EPVL)治疗;自然排石组不作处理。两组术后均采用多饮水,增加运动排石。比较两组结石大小、结石清除率、并发症。结果:2015年8月~2016年6月总共有65例患者入组,其中物理振动排石组(试验组)33例(男24例,女9例),自然排石组(对照组)32例(男26例,女6例),试验组和对照组平均年龄为(48.2±1.9)岁和(45.9±2.0)岁,P=0.417;试验组和对照组平均结石直径大小为(15.0±1.0)mm和(13.5±0.7)mm,P=0.237。试验组和对照组RIRS后第2、3和5周结石清除率分别为54.5%vs.21.9%、75.8%vs.46.9%和90.9%vs.56.3%,两组比较差异有统计学意义(P<0.05)。试验组与对照组比较,RIRS术后第2、5周血尿发生率较低,分别为54.5%vs.81.3%和3.0%vs.25.0%,差异有统计学意义(P<0.05)。结论:RIRS联合EPVL可以加快RIRS术后肾下盏残余结石的排出和提高结石的清除率。
OBJECTIVE: To evaluate the efficacy and safety of the physical lithotripsy device in the treatment of residual calyx after ureteroscopic soft lithotripsy (RIRS). Methods: A prospective randomized controlled study was conducted in which all patients with urolithiasis who met the inclusion criteria were randomly divided into physical vibration rowing group and natural rowing group in vitro. In vitro physical vibration row of stone group in the RIRS after physical vibration row stone machine (EPVL) treatment; natural row of stone group without treatment. After the two groups were used to drink more water, increase exercise row of stone. Compare the two groups of stone size, stone clearance rate, complications. Results: A total of 65 patients were enrolled in the study from August 2015 to June 2016, of which 33 were physical vibration row stone group (experimental group) (24 males and 9 females), natural row stone group (control group) 32 (26 males and 6 females). The average age of the experimental group and the control group was (48.2 ± 1.9) years and (45.9 ± 2.0) years, P = 0.417. The average diameter of the stones in the experimental and control groups was (15.0 ± 1.0) mm and (13.5 ± 0.7) mm, P = 0.237. The stone clearance rate of the experimental group and the control group after the RIRS were 54.5% vs.21.9%, 75.8% vs.46.9% and 90.9% vs.56.3%, respectively, with significant difference between the two groups (P <0.05). Compared with the control group, the incidence of hematuria in the first and second week after RIRS was 54.5% vs.81.3% and 3.0% vs.25.0%, respectively, with significant difference (P <0.05). Conclusion: RIRS combined with EPVL can accelerate the residual renal calyx after RIRS discharge and improve the stone clearance rate.