Feasibility and Optimization of Daily Intervention Measures for Postoperative Recurrence Prevention of Urinary Calculi
尿路结石术后复发预防日常干预措施的可行性及优化

1. Purpose of the Research
1. 研究目的

Urinary calculi (Kidney stones) is among the most frequent urological diseases globally. They impact millions of patients each year, although a large percentage of such patients are prone to developing other episodes after surgery (Scales et al., 2012). This recurrent nature also impacts on the quality of a patient’s life by causing significant discomfort. While this is detrimental to stimulating optimum patient health and subsequently decreases overall quality of life; it also creates substantial financial and operational costs to the healthcare systems in various countries globally (Moe, 2006). In China, and especially within large urban areas including Wuhan, there has been increasing evidence of the occurrence of urinary calculi as a result of changes in dietary practices, exercise patterns as well as environmental factors (Liu et al., 2018). Thus, it is possible to point out the need for identifying proper approaches to minimizing the postoperative risk of ureteral calculi relapse.
尿路结石（肾结石）是全球最常见的泌尿系统疾病之一。它们每年影响数百万患者，尽管其中很大一部分患者在手术后容易发生其他发作（Scales 等人，2012 年）。这种反复发作的性质也会通过引起严重的不适来影响患者的生活质量。虽然这不利于刺激患者的最佳健康，并随后降低整体生活质量;它还给全球各国的医疗保健系统带来了巨大的财务和运营成本（Moe，2006 年）。在中国，尤其是在包括武汉在内的大城市地区，越来越多的证据表明，由于饮食习惯、运动方式和环境因素的变化，尿路结石的发生（Liu et al.， 2018）。因此，可以指出需要确定适当的方法来降低输尿管结石复发的术后风险。

The major aim of this study is to determine the feasibility and optimize daily intervention measures aimed at reducing the recurrence rate of urinary calculi after surgery. Mitigating this problem is critical in order to improve patient care and outcome, increase the effectiveness of postoperative care, and to decrease cost of recurrent lithotripsy for kidney stone management (Pearle et al., 2014). Even though such general preventive measures are available, compliance with daily care interventions can be considered low (Fink et al., 2020). This lack of evidence necessitates population-based postoperative preventive intervention research that focuses on practical and sustainable preventive solutions.
本研究的主要目的是确定可行性并优化日常干预措施，以降低术后尿路结石的复发率。为了改善患者护理和结果，提高术后护理的有效性，并降低肾结石管理的复发性碎石术的成本，缓解这个问题至关重要（Pearle 等人，2014 年）。即使有这样的一般预防措施，对日常护理干预的依从性也可以被认为是低的（Fink et al.， 2020）。这种证据的缺乏使得基于人群的术后预防干预研究有必要，重点是实用和可持续的预防解决方案。

For this study, a scoping literature review was done to review literature on postoperative prevention and potential interventions for the development of urinary calculi among patients. Systematic and selective searches were conducted in databases including PubMed, Scopus, and Web of Science using terms like “urinary calculi recurrence” and “kidney stone prevention” and “postoperative management of kidney stones” and “daily measures for kidney stones”. Only the articles that were published between 2013 and 2023 were included to consider more recent and highly relevant data. The current research gaps include the lack of focused studies on practically translating daily interventions and rarely on evaluating the feasibility and optimisation of such daily interventions for patients with psychosis (Peters et al., 2015).
在这项研究中，进行了范围界定文献综述，以回顾有关术后预防和患者尿路结石发展的潜在干预措施的文献。在包括 PubMed、Scopus 和 Web of Science 在内的数据库中，使用“尿路结石复发”和“肾结石预防”和“肾结石的术后管理”和“肾结石的日常措施”等术语进行了系统和选择性检索。仅纳入 2013 年至 2023 年间发表的文章，以考虑更新且高度相关的数据。目前的研究差距包括缺乏关于实际翻译日常干预的重点研究，并且很少评估此类日常干预对精神病患者的可行性和优化（Peters 等人，2015 年）。

The guiding research question for this study is: What are the most feasible and effective daily intervention measures for preventing postoperative recurrence of urinary calculi?
本研究的指导性研究问题是：预防尿路结石术后复发最可行和最有效的日常干预措施是什么？

1a. Literature Pertaining to the Selected Approach
1a. 与所选方法有关的文献

In this sense, this study can be a very important contribution to close these gaps and to take the initial step towards future intervention. This scoping review method allows the current study to systematically and systematically fill gaps and laying the groundwork for the possible interventions to come. As an example, Fink et al. (2020) in their systematic review on dietary prevention of renal stone failed to consider that regional specific dietary interventions are important as there is difference in eating culture and environmental. Results specified here explain why such prevention approaches should be developed in the light of sociocultural and healthcare environment of the given region.
从这个意义上说，这项研究可以成为缩小这些差距并迈出未来干预第一步的非常重要的贡献。这种范围界定审查方法使当前研究能够系统地填补空白，并为可能的干预措施奠定基础。例如，Fink 等人（2020 年）在他们关于肾结石饮食预防的系统评价中未能考虑到区域特定的饮食干预很重要，因为饮食文化和环境存在差异。此处指出的结果解释了为什么应根据特定地区的社会文化和医疗保健环境制定此类预防方法。

The healthcare research literature has more recently embraced the scoping review method as a useful means of identifying future research directions and evidence gaps. Peters et al., (2015) note that scoping review is useful in mapping out the scope and nature of work being conducted to provide an exhaustive as well as informative view of available literature as well as identification of the gap area. With such a fragmented or heterogeneous literature, other researchers, including Munn et al. (2018) have also acknowledged that scoping reviews could be used see, for example, interventions to prevent recurrent kidney stones. These findings extend the suitability of using a scoping literature review.
医疗保健研究文献最近接受了范围界定审查方法作为确定未来研究方向和证据差距的有用手段。Peters 等人（2015 年）指出，范围界定审查有助于确定正在进行的工作的范围和性质，以提供现有文献的详尽和翔实的观点以及差距区域的确定。面对如此零散或异质的文献，包括 Munn 等人（2018 年）在内的其他研究人员也承认，范围审查可用于预防复发性肾结石的干预措施。这些发现扩展了使用范围界定文献综述的适用性。

This study can help to fill these gaps and provide the first step towards future intervention. This scoping review method, by systematic identification and mapping of some of the studies, allows the current study to systematically fill up the gaps and put the basis for developing possible interventions. For example, Fink et al. (2020) in their systematic review of dietary prevention of renal stone neglected the role of regional specific dietary interventions because of the eating culture and environmental differences. The specified results explain why such prevention approaches should be developed for the given sociocultural and healthcare environment of the given region.
这项研究可以帮助填补这些空白，并为未来的干预提供第一步。这种范围界定审查方法，通过系统地识别和绘制一些研究，使当前研究能够系统地填补空白，并为开发可能的干预措施奠定基础。例如，Fink 等人（2020 年）在他们对肾结石饮食预防的系统评价中，由于饮食文化和环境差异，忽视了区域特定饮食干预的作用。指定的结果解释了为什么应该针对给定地区的特定社会文化和医疗保健环境开发此类预防方法。

This study adopts the positivism research paradigm, which argues for breakthrough collection and analysis of factual evidence in order to arrive at measurable and generalizable results. Therefore, positivism is rather relevant in evaluating the quantifiable results on intervention methods for postoperative urinary calculi recurrence. It also assumes that structured data collection techniques and statistical solutions are practical tools for over- tempting the efficiency of the particular daily preventive activities.
本研究采用实证主义研究范式，主张对事实证据进行突破性的收集和分析，以得出可衡量和可推广的结果。因此，实证主义在评估术后尿路结石复发干预方法的可量化结果方面相当相关。它还假设结构化数据收集技术和统计解决方案是过度诱惑特定日常预防活动效率的实用工具。

For example, a survey by DiMatteo et al. (2021) on patient adherence to treatment plans in chronic diseases provided evidence that sociocultural beliefs and self-motivations effect adherence to physician’s directions. Using this knowledge, qualitative findings obtained in the subsequent focused sessions will provide valuable information regarding cultural practices, beliefs, and life behaviors of the population of Wuhan that may affect patients’ adherence to preventive practices.
例如，DiMatteo 等人（2021 年）关于慢性病患者对治疗计划的依从性的一项调查提供了证据表明，社会文化信仰和自我激励会影响对医生指示的依从性。利用这些知识，在随后的重点会议中获得的定性结果将提供有关武汉人口的文化习俗、信仰和生活行为的宝贵信息，这些信息可能会影响患者对预防措施的依从性。

The scoping review approach also ensures wider coverage of all types of evidence sources which include clinical trials, observational studies and qualitative research studies. This breadth of evidence allows the identification of the existing postoperative prevention practice and their performance to develop practical and effective intervention plans. For example, a systematic review about fluid intake in kidney stone disease revealed clinical guidelines and patient preferences, proving the need for using multiple styles of data (Shirazi et al., 2014).
范围界定审查方法还确保更广泛地涵盖所有类型的证据来源，包括临床试验、观察性研究和定性研究。这种广泛的证据允许确定现有的术后预防实践及其表现，以制定实用有效的干预计划。例如，一项关于肾结石疾病液体摄入量的系统评价揭示了临床指南和患者偏好，证明了使用多种数据风格的必要性（Shirazi 等人，2014 年）。

Therefore, the use of a scoping literature review research methodology being guided by the positivist paradigm is suitable for this study. This approach affords a structure and coverage of previous findings supplementing prior knowledge with current evidence acknowledging that the context of the study will be set within the sociocultural landscape of Wuhan. Moreover, the possibilities for designing daily postoperative interventional prevention strategies are also discussed in this study.
因此，使用以实证主义范式为指导的范围界定文献综述研究方法适用于本研究。这种方法提供了先前发现的结构和覆盖范围，用当前证据补充了先验知识，承认研究的背景将设置在武汉的社会文化景观中。此外，本研究还讨论了设计日常术后干预预防策略的可能性。

2. Study Design and Methods
2. 研究设计和方法

This research shall use quantitative, quasi experimental design to evaluate feasibility and efficacy of daily prevention measures following urinary calculi surgeries. A quasi-experimental design is well suited for this study as it allows for comparing the results of the intervention between two groups without having to randomly assign the participants, which poses obvious ethical and practical problems that are typical for clinical research (Maciejewski, 2020). 100 postoperative urinary calculi patients will be collected from the major hospitals and urology clinics in Wuhan area. While the intervention group will have a schedule of postoperative daily structured intervention, the control group will follow general post-surgical management. The intervention plan will include legal advice on drinking, change of diet regimes, and exercise, as well as, taking of medicines. Monthly follow up would be done after three weeks in the form of assessment, to check adherence as well as outcomes.
本研究应采用定量、准实验设计来评价尿路结石手术后日常预防措施的可行性和有效性。准实验设计非常适合本研究，因为它允许比较两组之间的干预结果，而无需随机分配参与者，这带来了明显的伦理和实际问题，这些问题是临床研究中的典型问题（Maciejewski，2020 年）。将从武汉地区的主要医院和泌尿外科诊所收集 100 名术后尿路结石患者。虽然干预组将有术后每日结构化干预的时间表，但对照组将遵循一般的术后管理。干预计划将包括有关饮酒、改变饮食习惯、锻炼以及服药的法律建议。三周后将以评估的形式进行每月随访，以检查依从性和结果。

3. Participant Identification, Approach, and Recruitment
3. 参与者识别、方法和招募

(i) Identification: Patients who have had urinary calculi within the past six months in Wuhan General Hospital will be sourced from the EHR of the hospital. The inclusion criteria will aim will be on subjects aged between 18 and 65 years who have provided informed assent for post-operation follow up. These patients will be excluded: those with chronic kidney disease or metabolic disorders, or those who cannot give informed consent.
（i） 身份证明：过去六个月内在武汉总医院患有尿路结石的患者将来自医院的 EHR。纳入标准将针对年龄在 18 至 65 岁之间且已为术后随访提供知情同意的受试者。这些患者将被排除在外：患有慢性肾病或代谢紊乱的患者，或无法给予知情同意的患者。

(ii) Approach: Targeted patients will first be contacted through a call and subsequent email from the urology department of their preferred hospital. Besides, approximately informational posters will be placed in the urology outpatient clinic and waiting areas containing information about the aims and conditions of the study.
（ii） 方法：目标患者将首先通过电话和随后的电子邮件从他们首选医院的泌尿科联系。此外，将在泌尿外科门诊和等候区放置大约信息海报，其中包含有关研究目的和条件的信息。

(iii) Recruitment: Patients with interest in the study will be called to the hospital for an informative session where they will be provided with full details of the study together with the possible benefits and adverse effects. All the screened patient who will show some form of interest will be given an informed consent form. Upon getting the written consent from the planned participants, they will be considered as part of the study, and will be subjected to baseline tests.
（iii） 招募：对研究感兴趣的患者将被召集到医院进行信息会议，在那里他们将获得研究的全部细节以及可能的好处和不利影响。所有将表现出某种形式兴趣的筛选患者都将获得知情同意书。在获得计划参与者的书面同意后，他们将被视为研究的一部分，并将接受基线测试。

Control Group Recruitment: This group will be composed of postoperative urinary calculi who do not receive any postoperative daily interventional care despite monitoring their postoperative care. These participants will be selected from the same patients and will also be contacted in the same manner as the other patients.
对照组招募：该组由术后尿路结石组成，尽管监测了他们的术后护理，但他们没有接受任何术后日常干预护理。这些参与者将从相同的患者中选择，并且也将以与其他患者相同的方式联系。

4. Research Procedures
4. 研究程序 

Participants in this study will first complete a detailed baseline assessment on medication use and past medical history, including a history of urinary calculi. This assessment will ensure that several areas of participants’ lives are reviewed including diets, hydration, exercise and medication whether is prescribed for kidney stone prevention or treatment (Boarin et al., 2018). By setting up such benchmark, the study will be in a position to get baseline measures of risk factors and also develop targeted interventions relevant to each of the participants’ health status. The benefits of using this approach is that it allows for intervention of every participant to be both appropriate and appropriate.
本研究的参与者将首先完成对药物使用和既往病史（包括尿路结石病史）的详细基线评估。该评估将确保审查参与者生活的多个领域，包括饮食、补水、运动和药物，无论是用于肾结石预防还是治疗（Boarin 等人，2018 年）。通过建立这样的基准，该研究将能够获得风险因素的基线测量，并制定与每个参与者的健康状况相关的针对性干预措施。使用这种方法的好处是它允许每个参与者的干预既适当又适当。

After the baseline measurements, the participants will be engaged in a daily personally tailored intervention plan. Participants will consume adequate amounts water in prevention of formation of kidney stone (Peerapen and Thongboonkerd, 2023). Participants will also be advised to engage in lesser sedentary actions and those who will be on certain medications will be encouraged to strictly follow doctor’s advice.
基线测量后，参与者将参与每日个人定制的干预计划。参与者将摄入足量的水以防止肾结石的形成（Peerapen 和 Thongboonkerd，2023 年）。还将建议参与者减少久坐不动的行为，并鼓励那些将服用某些药物的人严格遵循医生的建议。

To ensure compliance, participants will be provided with informative tools in form of brochures and visuals. Formulation of individual behaviour change plans to enable the participants achieve specific daily behavioural goals. There will be follow up to determine compliance in the next six months, analysis of urinary markers will be done through laboratory tests as well as check for any initial report of kidney stones formation. Data would be collected by the participant log and the lab data. To maintain methodological rigour, a pilot study of 10 participants will help to strengthen and optimize the intervention materials, as well as the collection of data (Ismail et al., 2018). To ensure reliability across the study, standard procedures for data collection will be employed, data will be audited frequently, and assessment tools will be tested.
为确保合规性，将向参与者提供小册子和视觉效果形式的信息工具。制定个人行为改变计划，使参与者能够实现特定的日常行为目标。在接下来的六个月内将进行随访以确定依从性，将通过实验室测试进行尿液标志物分析，并检查是否有任何肾结石形成的初步报告。数据将由参与者日志和实验室数据收集。为了保持方法的严谨性，一项由 10 名参与者进行的试点研究将有助于加强和优化干预材料以及数据收集（Ismail et al.， 2018）。为确保整个研究的可靠性，将采用标准数据收集程序，经常审计数据，并测试评估工具。

4b. Data Analysis
4b. 数据分析

Quantitative data will be analyzed using descriptive and inferential statistics. Descriptive statistics will summarize participant demographics, adherence rates, and clinical outcomes. Inferential statistics, including t-tests and chi-square tests, will assess the effectiveness of interventions in preventing recurrence (Cohen et al., 2017). A p-value of <0.05 will be considered statistically significant. Data analysis will be conducted using SPSS software.
将使用描述性和推理性统计数据对定量数据进行分析。描述性统计将总结参与者的人口统计数据、依从率和临床结果。推论统计，包括 t 检验和卡方检验，将评估干预措施在预防复发方面的有效性（Cohen et al.， 2017）。% 3C0.05 的 p 值将被视为具有统计显著性。将使用 SPSS 软件进行数据分析。

5. Ethical Considerations
5. 道德考虑

Ethical considerations are paramount in this study. Informed consent will be obtained from all participants, ensuring they understand the study's purpose, procedures, and their right to withdraw at any time (Sil and Das, 2017). Participant confidentiality will be maintained by assigning unique identification codes and storing data securely. As this study involves standard postoperative care with no invasive procedures, risks to participants are minimal. The study will be reviewed and approved by the University of Glasgow Research Ethics Committee
在这项研究中，道德考虑是最重要的。将获得所有参与者的知情同意，确保他们了解研究的目的、程序以及他们随时退出的权利（Sil 和 Das，2017 年）。参与者的机密性将通过分配唯一的识别码和安全存储数据来维护。由于这项研究涉及标准的术后护理，没有侵入性手术，因此对参与者的风险很小。该研究将由格拉斯哥大学研究伦理委员会审查和批准

6. Potential Benefits and Risks
6. 潜在的好处和风险

While participants may not directly benefit from the study, their involvement could contribute to improved postoperative care for future patients. The interventions are based on standard medical advice, posing minimal risk.
虽然参与者可能不会直接从这项研究中受益，但他们的参与可能有助于改善未来患者的术后护理。干预措施基于标准的医疗建议，风险最小。

7. Investigators and Qualifications
7. 研究者和资格

The research will be conducted under the supervision of experienced faculty members in urology and public health, with additional support from a research assistant skilled in data collection and analysis. A collaborating investigator with expertise in epidemiological studies of kidney stones will also provide guidance.
该研究将在泌尿外科和公共卫生领域经验丰富的教职员工的监督下进行，并得到擅长数据收集和分析的研究助理的额外支持。具有肾结石流行病学研究专业知识的合作研究者也将提供指导。

8. Emergency Arrangements
8. 紧急安排

Arrangements for provision of clinical facilities in emergencies are not required. The proposed intervention is a primary prevention of kidney stones through self-care behavioural changes and as such does not contain any surgical activities, high risk strategies, or clinical therapies that would require use of emergency departments.
不需要在紧急情况下安排提供临床设施。拟议的干预措施是通过自我护理行为改变来预防肾结石，因此不包含任何需要使用急诊科的手术活动、高风险策略或临床治疗。

9. Access to Participant Information
9. 访问参与者信息

Participants’ data will be retrieved from patient case files in health facilities with participants’ permission and consent. For ethical consideration we shall get permission from the University of Glasgow’s Research Ethics Committee. In case more approvals are required from outside or local committees, they will be pursued correspondingly.
在参与者允许和同意的情况下，将从医疗机构的患者病例档案中检索参与者的数据。出于伦理考虑，我们将获得格拉斯哥大学研究伦理委员会的许可。如果需要外部或地方委员会的更多批准，将相应地进行审批。

10. Recruitment of Students or Dependent Individuals
10. 招收学生或受抚养人

No students or dependent members will be included in this study.
本研究将不包括学生或受抚养成员。

11. Exclusion of Vulnerable Populations
11. 排除弱势群体

This study shall not comprise of children, those with mental illness or disorders, or those with intellectual disability. The reason for this decision is related to the nature of the trial that involves only adults who had at least one episode of urinary calculi and calculates the impact of lifestyle changes. These groups are excluded to keep the research on a population which can voluntarily participate in research and comprehend the research protocols and risks involved.
本研究不应包括儿童、患有精神疾病或障碍的人或智力障碍的人。做出这一决定的原因与试验的性质有关，该试验仅涉及至少发作过一次尿路结石的成年人，并计算生活方式改变的影响。这些群体被排除在外，以保持对可以自愿参与研究并理解研究方案和所涉及的风险的人群进行研究。

12. Incentives
12. 激励措施

No financial incentives will be provided. Participants will receive a thank-you note in appreciation of their time and contribution.
不会提供经济激励。参与者将收到一封感谢信，以感谢他们的时间和贡献。

13. Informed Consent
13. 知情同意

Consent will be obtained through a clear and straightforward process where participants are fully informed about the study's purpose, procedures, risks, and benefits. They will be told that participation is voluntary and they can withdraw at any time without consequence. A consent form will be provided for participants to sign, ensuring their understanding and agreement. Participants will also be given an information sheet that outlines the study details, confidentiality assurances, and their right to ask questions before and during the study. The signed consent form will be securely stored for record-keeping.
将通过一个清晰明了的过程获得同意，参与者可以充分了解研究的目的、程序、风险和益处。他们将被告知参与是自愿的，他们可以随时退出而不会产生任何后果。将提供一份同意书供参与者签署，以确保他们的理解和同意。参与者还将获得一份信息表，其中概述了研究细节、保密保证以及他们在研究之前和期间提出问题的权利。签署的同意书将被安全存储以备记录。

14. Cultural and Social Considerations
14. 文化和社会考虑

Cultural dietary practices will be considered when recommending interventions, ensuring inclusivity.
在推荐干预措施时，将考虑文化饮食习惯，确保包容性。

15. Data Storage and Confidentiality
15. 数据存储和保密

Data will be accessible only to the research team. It will be stored securely on password-protected computers and encrypted drives, with consent forms and identifiable data stored separately in locked cabinets. Data will be retained for five years and anonymised or pseudonymised where possible to maintain confidentiality. All data handling will comply with the Data Protection Act (2018) and GDPR guidelines, and data will be securely disposed of after the retention period.
只有研究团队才能访问数据。它将安全地存储在受密码保护的计算机和加密驱动器上，同意书和可识别数据单独存储在上锁的柜子中。数据将保留五年，并在可能的情况下进行匿名或假名化以保持机密性。所有数据处理均符合《数据保护法》（2018 年）和 GDPR 指南，并且数据将在保留期后得到安全处置。

in a fully anonymised form (link to participant broken),
以完全匿名的形式（参与者的链接已损坏），

(c) in a form in which the participant could be identifiable to researcher.
（c） 以研究人员可以识别参与者的形式。

16. Participant Involvement in Other Research
16. 参与者参与其他研究

No, the intended group of research participants will not be involved in other research.
不，预期的研究参与者群体不会参与其他研究。

17. Location of Study
17. 学习地点

The study will be conducted in leading hospitals and urology clinics across Wuhan, China.
该研究将在中国武汉的领先医院和泌尿外科诊所进行。

18. Budget and Funding
18. 预算和资金

The study budget will cover educational materials, data management tools, and personnel support. Funding applications will be submitted to relevant research grants. See Appendix 1.
研究预算将涵盖教育材料、数据管理工具和人员支持。资助申请将提交给相关研究资助。见附录 1。

19. Dissemination of Results
19. 结果的传播

The research findings will be disseminated through a peer-reviewed journal article, presentations at relevant conferences, and summaries shared with the academic community through presentations at relevant conferences, particularly in the fields of urology and public health. Additionally, key findings will be made available in plain language for broader public accessibility.
研究结果将通过同行评审的期刊文章、在相关会议上的演讲以及通过在相关会议上的演讲与学术界分享的摘要进行传播，特别是在泌尿外科和公共卫生领域。此外，主要调查结果将以通俗易懂的语言提供，以便更广泛的公众访问。

20. Study Limitations
20. 研究局限性

A particular limitation is related to the possibility of the participants’ self-reporting the levels of daily intervention compliance, which might be either inaccurate or intentionally distort the results. Such a bias could be due to inability to remember or reluctance to admit shortcomings, or misperception of the necessary features of an intervention. Furthermore, inconsistency in the performance, coupled with deviation of participants to set routines also present the other challenge (Hugtenburg et al., 2013).
一个特别的限制与参与者自我报告日常干预依从性水平的可能性有关，这可能是不准确的或故意扭曲的结果。这种偏倚可能是由于无法记住或不愿意承认缺点，或对干预的必要特征的误解。此外，表现的不一致，加上参与者对设定程序的偏差也带来了另一个挑战（Hugtenburg et al.， 2013）。

Another important study limitation is the low generalization of research data because all the research has been conducted directly in Wuhan. As these policies and interventions are developed to be culturally and contextually sensitive for this population type, they might not be useful or similar with other populations on different geographical, cultural or even having diverse healthcare systems (Movsisyan et al., 2019). Understanding these shortcomings is important to interpret the findings of the study and to inform subsequent lines of research focused on improving and diversifying postoperative management of urinary calculi.
另一个重要的研究局限性是研究数据的泛化程度低，因为所有研究都是直接在武汉进行的。由于这些政策和干预措施的制定对这一人群类型的文化和背景敏感，因此它们可能对不同地理、文化甚至拥有不同医疗保健系统的其他人群没有用或相似（Movsisyan et al.， 2019）。了解这些缺点对于解释研究结果并为后续研究方向提供信息非常重要，重点是改善尿路结石的术后管理和多样化。

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