倒置排石床治疗肾下盏残石的临床研究

摘要

Objective To evaluate the effect of inversion table dealing with lower pole renal stone fragments. Methods Seventy-nine patients with renal fragments less than 4 mm after initial percutaneous nephrolithotomy(PCNL) , shock wave litho-tripsy(SWL) ,or ureteroscopic lithotripsy(URL) were randomly divided into two groups. Study group(n = 40) was given inversion table, while control group (n= 39) was given dieresis therapy with patients' urine volume more than 2 000 mL every day. Plain abdominal radiography(KUB)was performed one month after therapy. Results All patients in study group were treated with inversion table successfully. There was no statistically significant difference in gender, age, body mass index, stone diameter, infundibular length, infundibular pelvic angle or infundibular width between two groups. The stone clearance rate in study group and control group was 75% and 41% respectively(P<0. 05). Conclusion The inversion table is an effective option for lower residual caliceal fragments after SWL,PCNL or URL.%目的 探讨倒置排石床辅助治疗肾下盏残石的作用.方法 79例经皮肾镜取石术(PCNL)、体外冲击波碎石术(SWL)和输尿管镜碎石术(URL)后出现肾下盏残石患者,残石直径小于4 mm,随机、对照、单盲分为实验组和对照组.实验组40例患者使用倒置排石床治疗.对照组39例患者每日多饮水,保持尿量2 000 mL以上.1个月后行腹部平片复查残石情况.结果 实验组患者均顺利完成倒置排石床治疗.实验组和对照组患者年龄、性别、BMI及残石的大小差异无统计学意义(P＞0.05).肾脏的解剖参数如肾下盏长度、肾下盏肾盂夹角和肾下盏盏颈宽度实验组和对照组差异无统计学意义(P＞0.05).1个月后实验组的残石清除率达到75％而对照组仅为41％ (P＜0.05).结论 倒置排石床可提高肾下盏残石的清除率,可以作为PCNL、SWL和URL术后的辅助治疗方法.