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MODERN ASPECTS OF TREATMENT OF PATIENTS WITH
Tojiev Shermukhammad Sheralievich
Alikulov Jakhongir Eshboltaevich
Berdiyorov Ramadan Sayriddinovich
Samarkand State Medical University, Samarkand, Uzbekistan
https://doi.org/
0.5281/zenodo.11445096
Annotation.
This thesis explores recent advancements in diagnosing and treating urolithiasis,
known as kidney stones. The core focus is on Improved diagnostic techniques: This includes
exploring advancements like dual-energy CT scanning and novel urine tests for risk
assessment. Emerging treatment options: Minimally invasive surgical techniques, refinements
in shock wave lithotripsy, and the development of new medications to prevent and pass
stones are covered. Dietary therapy: The role of nutritional modifications in urolithiasis
management is discussed. The thesis emphasizes that the optimal treatment path depends on
individual factors like stone characteristics and overall health. Consultation with a doctor is
crucial to determine the most suitable approach.
Keywords.
Kidney stones, Urolithiasis, Uroliths, Urolithiasis, Calcium stone, Oxalate stone,
Urate stone, Apatite stone, Lumbar pain, Weeping.
Relevance.
Urolithiasis is a medical condition characterized by the formation of stones in the
urinary tract, usually in the kidneys or bladder. These stones, known as urinary calculi or
kidney stones, are made up of crystallized minerals and can cause severe pain and discomfort
as they pass through the urinary system. A variety of factors, including dehydration, high
levels of certain minerals in the urine, and genetic predisposition can cause urolithiasis.
Treatment for urolithiasis may involve pain management, hydration, and, in some cases,
surgical removal of the stones. Prevention strategies may include adequate hydration, dietary
changes, and medications to control mineral levels in the urine.
Here are some new methods of diagnosis and treatment of urolithiasis:
Diagnosis
Dual-energy CT scanning: this type of CT scan can provide more information about the
composition of kidney stones, which can help doctors determine the best course of treatment.
Urine tests: new urine tests are being developed that can help identify patients who are
at risk for developing kidney stones.
Genetic testing: genetic testing may one day be used to identify patients who are
predisposed to developing kidney stones.
Treatment methods:
Minimally invasive surgical techniques: minimally invasive surgical techniques, such as
ureteroscopy and percutaneous nephrolithotomy, are becoming increasingly common for
treating kidney stones. These procedures allow doctors to remove stones with smaller
incisions, which can lead to a shorter recovery time.
Shock wave lithotripsy (SWL): SWL is a non-invasive procedure that uses sound waves
to break up kidney stones. This is a well-established technique, but researchers continue to
refine it to improve efficiency and reduce side effects.
Medications: New medications are being developed to help prevent kidney stones from
forming and to promote the passage of small stones.
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Dietary therapy: Dietary therapy can be an effective way to prevent kidney stones from
forming. A dietician can help you develop a plan that is right for you.
These are just a few of the new methods that are being used to diagnose and treat urolithiasis.
As research continues, even more effective treatments are likely to be developed.
It is important to note that not all of these new methods are appropriate for all patients. The
best course of treatment for you will depend on the size, location, and composition of your
kidney stones, as well as your overall health. Be sure to talk to your doctor about all of your
treatment options.
Among the various forms of manifestation of ICD, the most common are kidney stones, which
account for about 50% of clinical cases. Elimination of the cause of urinary stones has not
been resolved, while the provision that removing the stone should be a necessary part of
comprehensive treatment remains mandatory. Which, in turn, contributes to stone formation.
Treatment of nephrolithiasis has two main directions. One of them involves various methods
of removing urinary stones – these are symptomatic treatments for ICD. The second direction
includes methods of treating urolithiasis itself, considering its diverse etiological factors and
complex pathogenesis. Conservative treatment is possible in the presence of risk factors for
stone formation with a preventive purpose in crystalluria and stone excretion.
Surgical treatment of ICD is an arduous task. The high traumatism of traditional surgical
interventions was a prerequisite for the search for new methods of removing stones. Until the
end of the 70s of the XX century, the main method of treating patients with urolithiasis was
open surgery. Minimally invasive operations in cases of intraoperative complications end with
traditional surgical interventions.
A wide variety of new methods of treating nephrolithiasis: external shock wave lithotripsy
(ESWL), contact lithotripsy (CLT), percutaneous nephrolitho-lapaxia (PNL) pushed into the
background open methods of treatment of ICD.
The aim of the research.
To assess the clinical efficacy of various surgical treatment methods
of kidney stones.
Materials and methods.
The results of 50 kidney stone surgeries performed in patients
treated from 2007 to 2011 were analyzed. The age of the patients ranged from 21 to 75 years;
the mean age was 48 years. For representativeness, 50% of women and 50% of men were
included in the study.
All patients, depending on the method of surgical intervention, were divided into 4 groups: 1)
traditional open surgical treatment: pyelolithotomy or nephrolithotomy (63 patients); 2)
percutaneous nephrotic extraction – 83 patients; 3) external shock wave lithotripsy (ESWL)
(104 patients); 4) combined minimally invasive interventions – 17 patients.
Results and discussion.
It has been established that the duration of the postoperative period
of minimally invasive interventions is significantly shorter than after open ones. The time of
retroperitoneal drainage in open operations was 7 days, and in minilumbotomy – 6 days. In
the course of treatment, a decrease in the content of leukocytes of blood was observed in
patients after minimally invasive operations, and in patients after open nephrolithotomy on
the 3rd day, an increase in this parameter was noted. Kidney stones ranged from 25 to 65
minutes and averaged 38 minutes. The volume of blood loss was 150 ml after percutaneous
interventions and open operations are characterized by a much larger volume of blood loss -
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211 ml. Combined nephrolithotomy is indicated for large (more than 1.5-2.0 cm) and dense
(1000 HU and more) stones of the intrarenal pelvis.
Conclusion.
As a result of our study, it was revealed that the use of minimally invasive
methods in operations for kidney stones helps to reduce the period of disability by an average
of 20 days. Percutaneous operations should be used in the presence of contraindications to
ESWL. The use of the proposed techniques can reduce the time of postoperative rehabilitation
References:
1.
Khan S.R. Renal tubular damage/dysfunction: key to the formation of kidney stones //
Urological research. – 2006. – Т. 34. – №. 2. – С. 86-91.
2.
Karimov X. et al. GESTATSION PIYELONEFRIT: SAMARQAND VILOYATIDAGI HOLAT
//Наука и технология в современном мире. – 2024. – Т. 3. – №. 2. – С. 46-51.
3.
Kamalova D. GIPERPLASTIK JARAYONLAR VA PREMENOPAUZAL YOSH //Евразийский
журнал медицинских и естественных наук. – 2024. – Т. 4. – №. 4. – С. 254-258.
4.
Türk C., Petřík A., Sarica K., et al. EAU Guidelines on Interventional Treatment for
Urolithiasis // European Urology. – 2016. – Т. 69. – №. 3. – С. 468-474.
5.
Worcester E.M., Coe F.L. Clinical practice. Calcium kidney stones // New England Journal
of Medicine. – 2010. – Т. 363. – №. 10. – С. 954-963.
6.
Pearle M.S., Goldfarb D.S., Assimos D.G. et al. Medical management of kidney stones: AUA
guideline // Journal of Urology. – 2014. - Т. 192. - №. 2. - С. 316-324.
7.
Saidov N. et al. GIPERAKTIV QOVUQ SINDROMIDAGI O’ZGARISHLAR //Журнал
академических исследований нового Узбекистана. – 2024. – Т. 1. – №. 4. – С. 139-146.
8.
Shamatov I., Shopulotova Z. THE EFFECTIVENESS OF ULTRASOUND NON-PUNCTURE
TECHNOLOGY WITH ENDONASAL INTRADERMAL ANTIBIOTIC THERAPY IN THE
TREATMENT OF CHRONIC PURULENT POLYSINUSITIS //Science and innovation. – 2024. – Т.
3. – №. D4. – С. 307-311.
9.
Uralov S. et al. IMMUNOLOGICAL INDICATORS IN STENOSING LARINGOTRACHEITIS IN
CHILDREN //Science and innovation. – 2024. – Т. 3. – №. D1. – С. 81-86.
10. Wong Y., Cook P. Investigating and Managing Urinary Tract Stones // Nursing Times. -
2019. - Т. 115.
11. Yakubovich S. I. et al. EVALUATION OF THE CLINICAL EFFECTIVENESS OF ANTIBIOTIC
THERAPY IN COMBINATION WITH TOPICAL STEROIDS IN THE TREATMENT AND
PREVENTION OF RECURRENT BACTERIAL SINUSITIS //European International Journal of
Multidisciplinary Research and Management Studies. – 2024. – Т. 4. – №. 03. – С. 205-213.
12. Киямова Л. и др. ДИАГНОСТИКА СИНДРОМА ГИПЕРАКТИВНОГО МОЧЕВОГО
ПУЗЫРЯ //Theoretical aspects in the formation of pedagogical sciences. – 2024. – Т. 3. – №. 2.
– С. 138-145.
13. Киямова
Л.
и
др.
СОВРЕМЕННЫЕ
АСПЕКТЫ
ЛЕЧЕНИЯ
СИНДРОМА
ГИПЕРАКТИВНОГО МОЧЕВОГО ПУЗЫРЯ //Models and methods in modern science. – 2024.
– Т. 3. – №. 1. – С. 237-243.
14. Киямова Л. и др. СОВРЕМЕННЫЕ АСПЕКТЫ ГЕСТАЦИОННОГО ПИЕЛОНЕФРИТА
88
//Бюллетень студентов нового Узбекистана. – 2024. – Т. 2. – №. 1. – С. 27-31.
15. Пулатов У., Нематуллаев Ж., Шопулотова З. ОСТРЫЕ РЕСПИРАТОРНЫЕ ВИРУСНЫЕ
ИНФЕКЦИИ: СИМПТОМЫ, ЛЕЧЕНИЕ И ПРОФИЛАКТИКА //Евразийский журнал
медицинских и естественных наук. – 2024. – Т. 4. – №. 5. – С. 269-273.
16. Худоярова Д. и др. ПРАВОВЫЕ АСПЕКТЫ ЯТРОГЕНИИ В АКУШЕРСТВЕ //Молодые
ученые. – 2024. – Т. 2. – №. 4. – С. 110-113.
17. Худоярова Д. Р., Хайитбоев Д., Зубайдуллоева З. Х. СОВРЕМЕННЫЕ АСПЕКТЫ
ПОВЫШЕНИЕ АКТИВНОСТИ И РОЛИ ЖЕНЩИН В ОБЩЕСТВЕ //Молодые ученые. – 2024.
– Т. 2. – №. 5. – С. 147-151.
18. Шопулотов Ш. и др. ЛЕЧЕНИЯ НЕДЕРЖАНИЯ МОЧИ //Естественные науки в
современном мире: теоретические и практические исследования. – 2024. – Т. 3. – №. 1. –
С. 4-8.
19. Шопулотов Ш. и др. СТРУКТУРА ЭТИОЛОГИЧЕСКИХ ПРИЧИН ГИПЕРАКТИВНОГО
МОЧЕВОГО ПУЗЫРЯ //Центральноазиатский журнал образования и инноваций. – 2024.
– Т. 3. – №. 1 Part 2. – С. 56-60.
20. Шопулотов Ш. и др. ГЕСТАЦИОННЫЙ ПИЕЛОНЕФРИТ //Центральноазиатский
журнал образования и инноваций. – 2024. – Т. 3. – №. 1 Part 2. – С. 61-65.7.
