Application value of ultrasonic real time monitoring and adjusting treatment channel in extracorporeal shock wave lithotripsy
-
摘要: 目的:探讨超声实时监测并调整治疗通道在体外冲击波碎石(ESWL)中的应用价值。方法:选取我院2016年8月~2017年8月经腹超声定位ESWL治疗的输尿管上段结石患者186例,所有患者用超声预设理想的冲击波治疗通道并清晰定位后开始碎石,在冲击次数达到500次、电压达到8kV以上时,超声仔细监测结石无明显变化,按碎石先后次序交替随机分成两组:对照组和观察组各93例。对照组继续以预定的冲击次数直至治疗结束,观察组调整治疗通道后按预定的冲击次数直至治疗结束。结果:观察组、对照组治疗总有效率分别为82.8%和65.6%,两组比较差异有统计学意义(P<0.05);观察组、对照组并发症总发生率分别为59.1%和67.7%,两组比较差异无统计学意义(P>0.05)。结论:超声实时监测并调整治疗通道在ESWL中的应用是简单、方便的,可提高碎石有效率,且不会增加并发症的发生,值得在实际工作中推广和应用。Abstract: Objective: To evaluate the application of ultrasonic real time monitoring and adjusting treatment channel in extracorporeal shock wave lithotripsy (ESWL).Method: From August 2016 to August 2017, 186 cases of upper ureteral calculi who were treated with ESWL by ultrasound localization through the abdomen and diagnosed in our hospital were enrolled in this study.All patients were treated with ESWL by presetting the ideal shock wave treatment channel and clear positioning with ultrasound, when the shock numbers reached 500 times, the voltage reached 8 kv or more, the stones did not change significantly by ultrasonic monitoring.According to the sequence of ESWL, they were randomly and alternately assigned to 2 groups:the control group and the observation group (each group 93).The control group continued with a predetermined shock numbers until the end of treatment, while the observation group adjusted the treatment channel and continued with the scheduled shock numbers until the end of treatment.Result: The total effective rate of the observation group and the control group were 82.8% and 65.6% respectively, which there was statistically significant difference between them (P <0.05).The total incidence of complications in the observation group and control group were 59.1%, 67.7% respectively, which there was no significant difference between them (P>0.05).Conclusion: The application of ultrasonic real time monitoring and adjusting treatment channel in ESWL is simple and convenient, which can improve the successful rate of lithotripsy without increasing the occurrence of complications, so it is worthy of popularization and application in the practical work.
-
Key words:
- extracorporeal shock wave lithotripsy /
- ultrasound /
- real time monitoring /
- channel
-
-
[1] 那彦群, 叶章群, 孙颖浩, 等.中国泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社, 2014:129.
[2] 桂西青, 王桂珍, 郑巍.俯、侧与仰卧位ESWL治疗输尿管上段结石疗效比较[J].临床泌尿外科杂志, 2002, 17 (12):699-700.
[3] 许建喜.不同体位体外冲击波碎石术治疗输尿管上段结石疗效比较[J].山西医药杂志, 2008, 37 (15):750-751.
[4] 孙西钊, 丛小明, 叶章群.冲击波碎石技术的发展动态[J].临床外科杂志, 2011, 19 (2):77-79.
[5] Tailly G G.Extracorporeal shock wave lithotripsy today[J].Indian J Urol, 2013, 29 (3):200-207.
[6] 韩见知, 吴开俊.体外冲击波碎石技术[M].北京:人民卫生出版社.2004:11-16.
[7] 张东方, 孙璇, 牛姬飞, 等.冲击波碎石术中治疗深度与疗效的关系研究[J].实用医学杂志, 2010, 26 (21):3887-3889.
[8] 黄忠会, 黄凤瑞, 曹全斌.以肠梗阻征表现的输尿管结石25例临床分析[J].临床急诊杂志, 2006, 7 (1):25-26.
[9] Cleveland R O, Mcateer J A.Physics of Shock-Wave Lithotripsy[M]//Smith's Textbook of Endourology, Volume I&II, 3rd Edition.Wiley-Blackwell, 2012:527-558.
[10] Pishchalnikov Y A, Neucks J S, Vonderhaar R J, et al.Air pockets trapped during routine coupling in dry head lithotripsy can significantly decrease the delivery of shock wave energy[J].J Urol, 2006, 176 (6 Pt 1):2706-2710.
[11] Bohris C, Roosen A, Dickmann M, et al.Monitoring the coupling of the lithotripter therapy head with skin during routine shock wave lithotripsy with a surveillance camera[J].J Urol, 2012, 187 (1):157-163.
[12] 吴建惠, 何屹, 陈昊, 等.超声预设治疗通道在体外冲击波碎石中的应用价值[J].临床泌尿外科杂志, 2017, 32 (6):478-479.
-
计量
- 文章访问数: 299
- PDF下载数: 197
- 施引文献: 0
下载: