背景:在接受体外冲击波碎石(ESWL)手术的输尿管结石患者中,使用双J输尿管导管会降低手术的疗效或对结石发生率没有影响。然而,双J导管对感染肾积水患者的影响尚不清楚.我们研究的目的是评估ESWL手术在输尿管结石和先前插入的双J导管治疗肾积水的患者中的疗效和安全性。
方法:我们进行了病例对照比较,在2018年1月1日至2023年3月1日接受ESWL治疗的输尿管结石患者组中进行配对研究,根据双J导管的存在将患者分为两组.对于研究组的每位使用双J导管的患者,我们选择了一个没有使用双J导管的患者作为对照组,并在尺寸方面进行匹配,石头的位置,体重指数(BMI)。分析两组结石清除率及并发症发生情况。
结果:40例输尿管结石和双J导管用于感染肾积水的患者被纳入研究组。对照组包括40例未使用双J导管的输尿管结石患者。两组患者主要是男性,结石位于腰椎区域和右侧,BMI在25至30kg/m2之间。结石的平均大小为0.9+/-0.12mm和0.89+/-0.15mm,分别(p=0.624)。第一次ESWL治疗后,两组的结石发生率无统计学差异(47.5%vs.52.5%,p=0.502),第二个(70%vs.75%,p=0.616),和第三届会议(85%vs.87.5%,p=0.761)。两组的并发症发生率相似(7.5%vs.5%,p=0.761)。
结论:对于因感染肾积水而接受ESWL的输尿管结石患者,插入双J导管的存在并不影响手术的无结石率或并发症发生率。输尿管结石患者的ESWL手术和双J导管插入感染的肾积水是一种安全有效的方法,可以推荐作为逆行输尿管镜检查的初始治疗方法。
BACKGROUND: Double-J ureteral catheters in patients with ureteral lithiasis undergoing extracorporeal shockwave lithotripsy (ESWL) procedures reduce the efficacy of the procedure or have no effect on the stone-free rate. However, the effect of double-J catheters on the patients in whom they were inserted for infected hydronephrosis is not known. The aim of our study was to evaluate the efficacy and safety of the ESWL procedure in patients with ureteral lithiasis and double-J catheters previously inserted for infected hydronephrosis.
METHODS: We conducted a comparative case-control, match-paired study in a group of patients with ureteral lithiasis treated by ESWL from January 1, 2018, to March 1, 2023, who were divided into two groups according to the presence of the double-J catheter. For each patient with the double-J catheter from the study group, we selected one patient for the control group without the double-J catheter and matched them in terms of size, location of stones, and body mass index (BMI). We analyzed the stone-free rate and complications that occurred in the two groups.
RESULTS: Forty patients with ureteral lithiasis and a double-J catheter inserted for infected hydronephrosis were enrolled in the study group. The control group included 40 patients with ureteral stones without double-J catheters. The patients in the two groups were predominantly men with stones located in the lumbar region and on the right side and with a BMI between 25 and 30 kg/m2. The stones had an average size of 0.9+/-0.12mm and 0.89+/-0.15mm, respectively (p=0.624). There was no statistically significant difference in stone-free rate between the two groups after the first session of ESWL (47.5% vs. 52.5%, p=0.502), the second (70% vs. 75%, p = 0.616), and the third session (85% vs. 87.5%, p=0.761). The rate of complications was similar in both groups (7.5% vs. 5%, p=0.761).
CONCLUSIONS: The presence of double-J catheters inserted in patients with ureteral stones who underwent ESWL for infected hydronephrosis does not affect the stone-free rate of the procedure or the complication rate. The procedure of ESWL in patients with ureteral lithiasis and double-J catheters inserted for infected hydronephrosis is a safe and efficient method that can be recommended as an initial treatment alongside retrograde ureteroscopy.