دراسة مضاعفات تفتيت الحصيات البولية (الكلية والحالب) بالأمواج الصادمة من خارج الجسم
Abstract
تقييم مدى أمان التفتيت بالأمواج الصادمة من خارج الجسم للحصيات البولية. طرائق البحث: 3 مجموعات من مرضى لديهم حصيات كلوية أو حالبية علوية، المجموعة A- 100 مريض خضعوا للـ ESWL وليس لديهم استخدام للمميعات أو اضطراب كلوي أو كبدي أو بنكرياسي، المجموعة B - 100 مريض لديهم استخدام للمميعات الدموية، المجموعة C - 100 مريض لديهم كلية وحيدة وظيفيا أو تشريحيا. المتابعة كانت باستخدام التصوير بالأمواج فوق الصوتية لأعضاء البطن والحوض، وإجراء التحاليل المخبرية (urea،cr ،alt ، ast، amilas) خلال الأسبوع التالي لجلسة التفتيت. أجريت دراسة إحصائية باستخدام قانوني ستيودنت وأنوفا. النتائج: كان معدل حدوث ورم دموي (10.5%)، وحدوث ارتفاع قيم البولة والكريتينين (27%، 5%) على التتالي، الارتفاع في قيم الخمائر الكبدية حوالي 12% دون أي يكون ذا دلالة مرضية واضحة، كذلك الارتفاع في قيم الأميلاز الذي لم يتجاوز 6%. يعتبر التفتيت بالأمواج الصادمة من خارج الجسم وسيلة سهلة التطبيق، غير غازية، فعالة، وآمنة في علاج الحصيات البولية، وذلك مع الانتباه لعوامل محددة تزيد من اختلاطاتها وتقلل من فعاليتها. Purpose: We evaluated the safety of ESWL (Extracorporeal Shockwave Lithotripsy). Materials and Methods: A total of 300 patients with stones located in the kidney or the upper ureter were randomly divided into 3 groups, group A—100 who received ESWL and they do not use anticoagulation drugs and thy do not have problems with kidneys, liver or pancreas B—100 who received ESWL and they use anticoagulation drugs C—100 who received ESWL and they have one kidney. Radiologic and laboratory follow up were performed in the first week by:US –UREA-CR-ALT-AST-AMILAS. Statistical analysis was performed using the chi square test and Anova test. Results: The hematomas rate was 10.5%.Rates elevation of urea and cr was (27%, 5%). Rate elevation of alt–ast was 12%, and for amylase was 6%, without clear pathology. Conclusions: ESWL is an easy, noninvasive, safe and active management of the urinary stones, and we should be care full with some factors, which can increase its complications and decrease its activity.Downloads
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