Objective: To observe the clinical efficacy of external physical vibration lithecbole (EPVL) in the treatment of calculous renal colic under different positions. Method: A total of 120 calculous renal colic patients who underwent EPVL from September 2018 to September 2019, were randomly divided into three groups utilizing random number table: supine position group, the lateral position group and the hybrid position group, with 40 cases in each group. Prior to the EPVL, each patient was given an intravenous injection of 20 mg furosemide. When the patients accumulated enough urine, they began to undergo EPVL. Numeric Rating Scale (NRS) was applied to assess the pain intensity before and after the treatment. Furthermore, all the patients were examined by B-ultrasound or urinary CT a day and a week after the treatment. The NRS score, side effects, stone discharge rate, time of pain relief, and pain recurrence rate were compared among different groups. Results: Prior to the treatment, there was no significant difference of the pain intensity among three groups (P>0.05). After the treatment, the pain intensity considerably alleviated in all the groups. The NRS score decreased by 4.05±0.24, 3.23±0.23 and 2.90±0.21 in supine, lateral and hybrid position groups, respectively. The time of pain relief was (8.88±0.46) min, (10.33±0.44) min and (10.38±0.50) min in supine, lateral and hybrid position groups, respectively. Overall, the efficacy of lateral position group was better than the other two groups in terms of speed and degree of pain relief (P< 0.05). The total pain relief rate was 91.7%. However, the pain recurrence rate was 15.0% (6/40), 15.0% (6/40) and 12.5% (5/40) in supine, lateral and hybrid position groups, respectively, however, there was no significant difference among three groups (P>0.05). But the hybrid position group had a relatively low rate of pain recurrence. The aggregate stone discharge rate of three groups was 25.8% and 62.5% a day and a week after the treatment respectively. The calculus clearance rate of surgical day was 22.5% (9/40), 35% (14/40) and 20% (8/40) in supine, lateral and hybrid position groups, respectively. Moreover, the stone removal rate was 60% (24/40), 75% (30/40) and 52.5% (21/40) in supine, lateral and hybrid position groups, respectively. The result indicated that the supine position group had the highest stone discharge rate (P<0.05). Overall, there was no case with severe complications, and there was no significant difference of side effects among three groups (P>0.05). Conclusion: EPVL can safely and effectively improve calculous renal colic and assist the removal of stone. When calculous renal colic was treated under EPVL, the patients can benefit from all three positions, and thus it is crucial to decide which position is more appropriate in different scenarios.
目的： 观察不同体位行体外物理振动排石术（EPVL）治疗结石性肾绞痛的临床疗效。 方法： 浙江省江山市人民医院2018年9月至2019年9月期间被确诊为结石性肾绞痛的120例患者，按数字随机分组法分为仰卧位、侧卧位和杂交位3组进行EPVL治疗，每组各40例，治疗前均予速尿针20 mg静脉推注1次，憋尿后行EPVL治疗肾绞痛。所有入组患者治疗前、后均行疼痛强度数字评分法（NRS）评分，治疗后1 d、1周分别复查B超或泌尿系CT（CTU）。比较各组NRS差异、不良反应、结石排出率、疼痛缓解时间及疼痛复发率。 结果： 治疗前，3组患者的疼痛评分差异无统计学意义（P>0.05）。治疗后，3组患者肾绞痛均有显著缓解，侧卧位组、仰卧位组、杂交位组的NRS下降值分别为（4.05±0.24）、（3.23±0.23）、（2.90±0.21），疼痛缓解时间分别为（8.88±0.46）、（10.33±0.44）、（10.38±0.50）min，疼痛缓解速度及程度，侧卧位组治疗结石性肾绞痛效果优于其他两组，差异有统计学意义（P<0.05）；疼痛总好转率为91.7%，疼痛再发率分别为15.0%（6/40）、15.0%（6/40）、12.5%（5/40），3组差异无统计学意义（P>0.05），但杂交位组再发率低；3组患者结石的当日和1周总排出率分别为25.8%、62.5%，3组当日和1周排出率分别为22.5%（9/40）、35%（14/40）、20%（8/40）和60%（24/40）、75%（30/40）、52.5%（21/40），仰卧位组排出率最高（P<0.05）；无1例严重并发症，不良反应差异无统计学意义（P>0.05）。 结论： EPVL可以缓解结石性肾绞痛，安全有效，并能促进结石的排出。EPVL治疗肾绞痛时，3种体位各有优势，应视具体情况选择。.
Keywords: Posture; Renal Colic; Urinary calculi; Vibration.