不同频率的体外冲击波碎石术治疗输尿管结石的疗效
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四川省中医药管理局科学技术研究专项课题(2023MS574);


Effect of extracorporeal shock wave lithotripsy with different frequencies in treating ureteral calculi
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    摘要:

    目的:探讨不同频率的体外冲击波碎石术(EWSL)治疗输尿管结石的疗效。方法:选取564例输尿管结石患者为研究对象,按照EWSL冲击波频率不同分为中频组与高频组,每组各282例。中频组患者给予35次/min冲击波治疗;高频组患者给予60次/min冲击波治疗,术后均随访3个月。比较两组患者碎石时间、术后3个月排石率及结石排净率;术前及术后24 h疼痛程度(VAS评分)、肾血流指标[肾内脉动指数(PI)、肾内动脉阻力指数(RI)和肾动脉主干血流速度最大值(Vmax)]及肾功能指标[尿素氮(BUN)、尿肌酐(Cr)及肾小球滤过率(GFR)水平]及术后3个月内并发症发生情况。结果:高频组患者碎石时间低于中频组(P<0.05)。术后3个月,中频组排石率、结石排净率高于高频组(P<0.05)。术后6 h、1 d、3 d、2周,两组患者VAS评分均逐渐降低(P<0.05),且中频组各时间点均低于高频组(P<0.05)。术后24 h,两组患者PI、Vmax均降低(P<0.05),且高频组低于中频组(P<0.05);RI均升高(P<0.05),但高频组高于中频组(P<0.05);BUN、Cr水平均升高(P<0.05),且高频组高于中频组(P<0.05);GFR水平均降低(P<0.05),且高频组低于中频组(P<0.05)。术后3个月,中频组并发症总发生率低于高频组(P<0.05)。结论:35次/min与60次/min频率冲击波治疗输尿管结石效果均良好,但35次/min频率冲击波在提高患者结石排净率、减轻疼痛程度方面更优,对患者肾功能影响小,安全性较高。

    Abstract:

    Objective:To analyze the effect of different frequencies of extracorporeal shock wave lithotripsy(EWSL)in the treatment of ureteral calculi.Methods:564 patients with ureteral stones were included and divided into 282 cases each in the intermedi-ate frequency group and the high frequency group according to the different modes of intervention,and were treated with shock waves at frequencies of 35 times/min and 60 times/min,respectively.The stone fragmentation time,3-month postoperative stone removal rate,and stone clearance rate,preoperative and postoperative 24-hour pain level(VAS score),renal blood flow indicators[renal pulsatility index(PI),renal artery resistance index(RI),and maximum renal artery flow velocity(Vmax)],renal function indicators[urea nitrogen(BUN),urinary creatinine(Cr),and glomerular filtration rate(GFR)levels],and incidence of complications within 3 months after surgery were compared between the two groups.Results:The stone removal rate and stone clearance rate in intermediate frequency group were higher than those in high frequency group at 3 months after surgery(P<0.05),and the lithotripsy time was shorter in high frequency group than that in intermediate frequency group(P<0.05).At 6 h,1 d,3 d,and 2 w after surgery,the VAS score in the two groups was decreased after surgery(P<0.05),and the score in intermediate frequency group was lower than that in high frequency group(P<0.05).24 h affter surgery,both groups of patients showed a decrease in PI and Vmax(P<0.05),and high frequency group was lower than the intermediate frequency group(P<0.05).RI increased in both groups(P<0.05),and the high frequency group was higher than the intermediate frequency group(P<0.05).The levels of BUN and Cr both increased(P<0.05),and the high frequency group was higher than the intermediate frequency group(P<0.05).The GFR levels were all reduced(P<0.05),and the high frequency group was lower than the intermediate frequency group(P<0.05).The complications were lower in intermediate frequency group than those in high frequency group(P<0.05).Conclusion:Shock wave therapy at 35 times/min and 60 times/min have good effects in the treatment of ureteral calculi,but 35 times/min frequency shock wave is better in enhancing the stone clearance rate and relieving the pain degree,and it has smaller influence on renal function and it is safer and more effective.

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彭启洪;周婷婷;姬生军;.不同频率的体外冲击波碎石术治疗输尿管结石的疗效[J].川北医学院学报,2025,40(4):480-483.

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  • 在线发布日期: 2025-07-24
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