Abstract：Objective： To observe the curative effect of extracorporeal physical vibration lithecbole (EPVL) treatment for the patients with residual lower renal calyx calculi after retrograde intrarenal surgery (RIRS). Methods： Ninety cases of residual lower renal calyx calculi who underwent RIRS in our hospital from January 2018 to February 2019 were analyzed prospectively. The patients were divided into EPVL group and natural lithecbole group randomly. The EPVL group was given EPVL treatment, and the control group was subjected to the such natural lithecbole methods as drinking extra water, adding exercise moderately, etc. The clinical data of the curative effect, complications, side-effects and satisfaction of patients were collected and analyzed systematically by imaging analysis, laboratory examination and satisfaction grade. Result： In the EPVL group, 91.1% patients expelled stones in two days, the stone free rate at 1st and 2nd week was 77.8% and 88.9% respectively, and the satisfaction survey of patients scored 95.2. In the control group, 44.4% patients expelled stones at 2nd day, the stone free rate at 1st and 2nd week was 57.8% and 75.6% respectively, and the satisfaction survey of patients scored 76.4. There were significantly differences in the curative effect and the satisfaction grade between the two groups (P < 0.05). The ages, sex, distribution and size of stone had no significant difference between the two groups (P > 0.05). A few of the patients in the EPVL group had transient symptoms such as abdominal pain and itching. There were no serious side-effect and complications in both groups. Conclusion： EPVL treatment can effectively promote the lithecbole of residual lower renal calyx calculi after RIRS. It is a relatively safe and noninvasive treatment with no severe adverse reaction and a high level of satisfaction.
[1] 许长宝,王友志,褚校涵,等.物理振动排石机在上尿路结石体外冲击波碎石后的临床应用.中华泌尿外科杂志,2013,34(8):599-602.
[2] AL-KOHLANY KM, SHOKEIR AA, MOSBAH A, et al.Treatment of complete staghorn stones: A prospective randomized comparison of open surgery versus percutaneous nephrolithotomy. J Urol, 2005,173(2):469-473.
[3] GANPULE AP, DESAI MR.Urolithiasis in kidneys with abnormal lie, rotation or form. Curr Opin Urol, 2011,21(2):145-153.
[4] 梁丽芬,刘泉姣.运动及饮水方式指导对体外冲击波碎石术后排石效果的影响.全科护理,2009,7(20):1820-1821.
[5] PALMISANO F, SPINELLI MG, LUZZAGO S, et al.Medical expulsive therapy for symptomatic distal ureter stones: is the combination of bromelain and tamsulosin more effective than tamsuLosin alone? preliminary results of a Single-Center study. Urol Int, 2019,102(2):145-152.
[6] SRIDHARAN K, SIVARAMAKRISHNAN G.Medical expulsive therapy in urolithiasis: a mixed treatment comparison network meta-analysis of randomized controlled clinical trials. Expert Opin Pharmacother, 2017,18(14):1421-1431.
[7] WU WQ, YANG Z, Tang FL, et al.How to accelerate the upper urinary stone discharge after extracorporeal shockwave lithotripsy (ESWL) for < 15 mm upper urinary stones: a prospective multi-center randomized controlled trial about external physical vibration lithecbole (EPVL). World J Urol, 2018,36(2):293-298.
[8] TAO RZ, TANG QL.External physical vibration lithecbole facilitating the expulsion of upper ureteric stones 1.0-2.0 cm after extracorporeal shock wave lithotripsy: a prospective randomized trial. Urolithiasis, 2018,48(1):71-77.
[9] 邓国贤,胡婷,鄢俊安,等.物理震动排石临床疗效分析.局解手术学杂志,2014,5:451-452.
[10] GÓMEZ-BLANCO JC, MARTÍNEZ-REINA FJ, CRUZ D, et al. Fluid structural analysis of urine flow in a stented ureter. Comput Math Methods Med, 2016:5710798.
[11] 邓汪东,卢善明,杨峰涛.输尿管双J管在泌尿系疾病中的应用及亚甲蓝在置管时的辅助作用.中国医药,2012,7(9):1143-1144.
[12] TAGUCHI M, INOUE T, MUGURUMA K, et al.Impact of loop-tail ureteral stents on ureteral stent-related symptoms immediately after ureteroscopic lithotripsy: Comparison with pigtail ureteral stents. Investig Clin Urol, 2017,58(6):440-446.
