| Objective To investigate the effect of Extracorporeal Physical Vibration lithecole(EPVL)on the removal of residual kidney stones after Retrograde Intrarenal Surgery(RIRS)and analysis of influencing factors.Methods 322 patients with renal residual stone were enrolled in a retrospective singlecenter randomized controlled study after RIRS during December 2018 to December 2020,a total of 178 patients received extracorporeal physical vibration lithoplasty and Patients in the 144 control group increased their exercise and drank more water 3 days after RIRS.Imaging data,laboratory results,clinical symptoms,OABSS scores,pain scores,and quality of life scores were analyzed to compare the differences of the stone free rate,complication rate and various scoring indexes at different postoperative times after RIRS between the EPVL group and the control group.The stone free rate of the two groups after treatment was analyzed and we used Logistic regression statistical method to analyze the influencing factors of the stone free rate after EPVL.Results(1)In general and clinical data,there was no significant diference between the two groups,P>0.05.(2)It was statistically significant that the stone free rates of the two groups at 2 weeks,4 weeks and 6 weeks were 52.8%vs31.3%,70.2%vs49.3%and 88.8%vs63.2%,respectively,P<0.05.It was statistically significant that the stone removal rates of subrenal calyces and multiple calyces in the two groups were 87.2%vs60.3%and 82.9%vs51.2%,respectively,P<0.05.Within the two groups,the differences were not statistically significant that the stone free rates of upper calyx,center calyx and renal pelvis stones were 100.0%vs83.3%、94.1%vs84.6%.95.2%vs81.3%,respectively,P>0.05.After RIRS,the differences were not statistically significant that the incidence of hematuria and pyuria at 2 weeks were 78.1%vs82.6%、46.1%vs52.1%,within the two groups,P>0.05.Also,in the two groups,it was statistically significant that the positive rate of hemauria was accomplished 17.4%vs31.3%and 3.9%vs14.6%at 4 and 6 weeks,P<0.05.Within the two groups,it was statistically significant that the rate of pyuria was 10.1%vs22.2%,3.4%vs 13.2%at 4 and 6 weeks,P<0.05.Within the control group,four patients with lumbar pain were relieved after symptomatic treatment at 2 weeks after RIRS.Four patients in the EPVL group showed pruritus in the main oscillator pressing area in 2 weeks,after sy-mptomatic treatment,the indications of pruritus made strides significantly.In the two groups,it was statistically significant that the postoperative VAS score of the two bunches was(2.53±1.26)vs(3.21 ± 1.04),and the SF-36 score of two groups was(109.26± 7.21)vs(107.54± 7.03),P<0.05.EPVL group significantly improved pain symptoms and quality of life of patients compared with control group.(3)It was statistically significant that the OABSS scores were(4.35±0.78)vs(6.53±1.02)separately after RIRS within the two groups,P<0.05.Compared with the control group,EPVL group essentially progressed the side effects of pee capacity period.According to the stone discharge survey rating table,according to the scale control EPVL postoperative time recognition,platoon stone for the first time seen in line with expectations,overall satisfaction score respectively to row stone treatment(92.3±3.1)vs(86.4±2.8),(89.6±4.5)vs(87.3±4.2),(93.61±4.1)vs(87.6±4.3),compared two groups have significant difference(P<0.05).(4)Single factor analysis of stone residue after extracorporeal physical vibration lithotomy:no residue group and residual stones CT value,location,stones composition,physical vibration row stone time,IPA,IL and IW appear critical contrast(P<0.05).Binary Logistic multivariate regression analysis:Stone area,IPA,IL,IW is affecting the physical vibration row stone independent risk factors for postoperative calculi residual(P<0.05).Conclusion(1)This study suggests that EPVL group has obvious advantages over natural stone expulsion group,especially for inferior calyx and multiple calyx stones,and it is relatively safe.(2)The EPVL group decreased the frequency of postoperative complications compared with the control group.(3)Compared with the control group,the EPVL group had a significant improvement in pain and quality of life after RIRS.(4)This study showed that EPVL group improves the symptoms of urine storage and patient satisfactionwas more effectively than the control group.(5)Stone site(lower renal calyx),IPA,IL and IW were independent risk factors which affect stone residue after EPVL.(6)Postoperative stone residual often exists after RIRS,and EPVL provides a feasible and safe treatment scheme for patients with postoperative stone expulsion. |
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