Shock Wave Lithotripsy Yog Qhov Zoo Li ureteroscopy hauv Kev Kho Cov Me Nyuam Nrog Raum Pob Zeb Thiab Nws Muaj Kev Zoo Ntawm Lub Neej

AUA thiab European Association of Urology (EAU) cov lus qhia pom zoo kom cov menyuam muaj lub raum pob zeb<20 mm and ureteral stones be treated with ureteroscopy (URS) or shock wave lithotripsy (SWL), but these recommendations are based on stone clearance rates There was low-level evidence (Level of Evidence: C) and no evidence from patient-reported outcomes (PROs). Although URS and SWL have the same weight in recommendations, 80% of children with kidney stones still receive URS in clinical practice.

Nyem rau Cistanche rau mob raum

Thaum lub sijhawm 2020-2023, Pediatric Kidney Stone Care Improvement Network (PKIDS) tau ua qhov kev soj ntsuam yav tom ntej hauv cov menyuam yaus hnub nyoog 8-21 xyoo ntawm 30 lub chaw kho mob hauv North America los sib piv URS thiab SWL hauv lub raum thiab ureter. Cov teebmeem ntawm kev siv hauv pob zeb. Thawj qhov kawg ntawm txoj kev tshawb fawb yog pob zeb-dawb tus nqi ntsuas los ntawm ultrasound 6 (± 2) lub lis piam tom qab phais. Cov ntsiab lus kawm thib ob yog cov txiaj ntsig tau tshaj tawm rau tus neeg mob (PROs) tau soj ntsuam los ntawm Patient-Reported Outcomes Measurement Information System (PROMIS) thiab cov tsos mob ntawm cov zis ntawm 1, 3, 6, thiab 12 lub lis piam tom qab phais.

Txoj kev tshawb no suav nrog 1070 tus menyuam yaus uas tau txais URS thiab 197 tus menyuam yaus uas tau txais SWL. Lub hnub nyoog, poj niam txiv neej, thiab haiv neeg kev faib tawm ntawm ob pawg tau sib xws. Qhov nruab nrab pob zeb loj yog 6 hli (IQR 4, 9) hauv pawg URS thiab 7 hli (IQR 6, 9) hauv pawg SWL.

After adjusting for differences between groups, for urinary tract stones of different locations and sizes (only 3 children in the SWL group had stones >15 hli, uas tsis tuaj yeem txheeb xyuas), cov pob zeb tshem tawm ntawm pawg URS thiab SWL yog 74.5% (95% CI) raws li. 65.7, 83.3) thiab 68.6% (95% CI 59.7, 77.7), tsis muaj qhov sib txawv tseem ceeb (risk txawv [RD]=5.9, 95% CI -6.6, 18.5).

Piv nrog URS, SWL txo qhov mob hnyav, mob cuam tshuam, thiab cov tsos mob ntawm cov zis ib lub lis piam tom qab kev phais. Tsis muaj qhov sib txawv ntawm PROs ntawm ob txoj kev kho mob los ntawm 3 lub lis piam tom qab kev phais mus rau qhov kawg 3- hli tom qab kev soj ntsuam.

Ntawm cov menyuam yaus uas muaj lub raum pob zeb thiab cov pob zeb ureteral, SWL tau cuam tshuam nrog cov pob zeb zoo sib xws thiab cov neeg mob tau tshaj tawm lub neej zoo dua li URS. Cov txiaj ntsig no txhawb kev siv SWL txoj kev kho rau cov menyuam yaus thiab cov tub ntxhais hluas uas muaj pob zeb me me rau nruab nrab ntawm cov zis.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rauraumnoj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tswv yim.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv cov kab mob hauv lub raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.