Study On The Efficacy Of SWL Combined With Physical Vibration In The Treatment Of Lower Pole Kidney Stone

ObiectiveAnalysis of the efficacy of(Extemal Physical Viblation Lithecbole,EPVL(physical vibration lithotripsy)in the treatment of lower calyceal calculi after extracorporeal shock wave lithotripsy with(Extracorporeal Shock Wave Lithotripsy,ESWL)promoting stone excretion and improving stone-free rate.Clinical Data and MethodsA total of 144 eligible patients with extracorporeal lithotripsy from February 2018 to February 2020 were selected for retrospective analysis,including 96 males and 48 females.All patients were successfully treated with extracorporeal lithotripsy.After treatment,they were divided into physical vibration lithotripsy group(EPVL group)and natural lithotripsy group(control group)according to the different ways of stone excretion,with 72 cases in each group.In the physical vibration stone removal group,the Friend-1 physical vibration stone removal machine was used to assist the residual stone discharge,while in the natural stone removal group,traditional stone removal methods such as increasing the amount of drinking water(daily drinking water greater than 2000ml),properly increasing the amount of exercise,healthy lateral recumbent position and handstand were used to assist the residual stone discharge.No residual stone was observed by color Doppler ultrasound and plain film of urinary system after operation.The stone removal rate and stone clearance rate at different time points(1 week,2 weeks and 4 weeks),as well as the incidence of postoperative adverse reactions and complications were compared between the physical vibration stone removal group and the natural stone removal group.ResultsExtracorporeal shock wave lithotripsy was performed successfully in all cases.after lithotripsy,ultrasound images showed that the stone fragments fell off,the shape of the stone changed,the echo intensity weakened,the sound shadow faded,the edge became rough,and the lithotripsy effect was better.The larger stones could be treated by secondary lithotripsy.The stone removal rates of physical vibration lithotripsy group and natural lithotripsy group were compared with those of natural lithotripsy group:the stone removal rate on the same day after operation was 63%(46/72)vs39%(28/72),p=0.003),1 week after operation(72%(52/72)vs46%(33/72),p=0.001),and 2 weeks after operation(79%(57/72)vs63%(45/72),p=0.028).The stone removal rate of physical vibration lithotripsy group was compared with that of natural lithotripsy group.4 weeks after operation,the stone excretion rate was 89%(64/72)vs71%(51/72),p=0.007),and the postoperative stone clearance rate was 93%(67/72)vs68%(49/72),p=0.000).The stone-free rate,1-week,2-week,4-week stone-free rate and stone-free rate of patients in the p=0.000);EPVL group were significantly higher than those in the control group(P<0.05).The postoperative adverse reactions were compared between the EPVL group and the control group:hematuria(10%(7/72)vs7%(5/72)p=0.546),fever:3%(2/72)vs 3%(3/72)p=0.649.After treatment,there was no significant difference in the incidence of hematuria and fever between the EPVL group and the control group(P>0.05).ConclusionAfter extracorporeal lithotripsy combined with physical vibration lithotripsy can accelerate the excretion of residual stones,shorten the time of stone removal,improve the cure rate of calculi,and less adverse reactions and complications,high safety,easy for patients to accept.