Using Extracorporeal Shock Wave Lithotripsy of Kidney Stones and the Upper Third of the Ureters
Keywords:extracorporeal shock wave lithotripsy, renal hematoma, ethamsylate, tranexamic acid
The objective: of the study was evaluate efficiency and safety of ethamsylate and tranexamic acid administration for prevention of the hemorrhagic complications of ESWL.
Materials and methods. Patient with urinary stone diseases (stone localized in kidney or upper part of urether) without coagulation disorders and who did not take medicines that affect the blood coagulation system was included. All patient was undergo ESWL. The group І included 1400 patients who did not receive preventive antihemorrhagic therapy. Group II – 375 patients who received 250 mg ethamsilate intravenously before the ESWL session. Group III – 300 patients – 500 mg tranexamic acid intravenously. During the postoperative period, the occurrence of kidney hematomas, prolonged macrohematuria and the occurrence of diseases associated with hypercoagulation were assessed.
Results. Group I: hemorrhagic complications were found in 52 (3.71 %) patients; 19 (1.36 %) people had renal hematomas, and 33 (2.36 %) had prolonged macrohematuria. In group II –3 (0.8 %) patients had hematomas and 3 (0.8%) – prolonged macrohematuria. In the group ІІІ, there was no hematomas and only 2 (0.67 %) patients had macrohematuria. The number of hemorrhagic complications in the tranexamic acid group was lower than in the control one (p=0.006). More severe complications predominated in the control group, compared with patients receiving hemostatic. None of the experimental groups didn’t show an increase in the frequency of pathology associated with hypercoagulation.Conclusions. ethamsylate and tranexamic acid can reduces the likelihood of renal hematoma and prolonged macrohematuria after ESWL. We did not find any complications specific to these medicines. The use of tranexamic acid is much more effective than ethamsylate.
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