输尿管结石的内科治疗探讨

Evaluation of Expectant Treatments of Internal Medicine for Ureteral Calculi

目的探索输尿管结石的内科保守治疗方法。方法对70例输尿管结石患者首先给予内科保守治疗。包括山莨菪碱20mg,维生素K332mg静脉滴注;黄体酮40mg,2次/d肌注;硝苯地平10mg,3次/d口服。经内科保守治疗1周结石仍未排出体外者给予体外冲击波碎石(ESWL)或手术治疗。结果经内科保守治疗1周排出的结石中,结石横径≤9mm,排出率21%;结石横径≤7mm,排出率74%;结石横径≤5mm,排出率87%.结石成分分析以草酸钙结石为主(55.6%)。结论对于结石直径≤7mm的尿路结石可以首选内科保守治疗,≥9mm的结石在内科保守的同时应积极准备接受手术或ESWL治疗。

Objective To evaluale the expectant treatments of internal medicine for ureteral calculi. Methods Severity patients with ureleral calculi reeieved expectant treatments as follows： Anisodamine 20mg, VitK3 32mg intravenous drip;Progesterone 40rag intramuscular i njectionlwice per day; Nifedipine 10mg peros, ter in die. After a week, patients whose stones are not eliminated received Extracorporeal Shake Wave Lithotripsy（ ESWL） or surgery. Results After a week＇ s therapy, diameter≤9mm, ≤ 7mm, ≤ 5mm, the stones elimination rate is 21%, 74%, 87% respectively. Calcium oxalate calculus predominates（55.6% ）, Conclusion if the statue＇s diameter≤7mm,the expectant treatments can be taken first;diameter≥ 9mm, surgery or ESWL should be prepared simultaneously.