体外震波碎石配合总攻疗法治疗泌尿系结石的效果观察

Efficacy of extracorporeal shock wave lithotripsy combined with general attack therapy

目的 观察体外震波碎石配合总攻疗法治疗泌尿系结石的临床效果。方法 选择100例结石大小为0．8～2．0cm以内。无禁忌证的泌尿系结石病人。随机分成实验组（51例）及对照组（49例）。实验组行体外震波碎石后配合总攻排石治疗；对照组行体外震波碎石后嘱病人大量饮水、跳跃。2组病人碎石前均经B超或静脉肾盂造影，腹平片确诊结石大小、形状、部位、性质；检查血、尿常规及出凝血时间，必要时检查心电图、胸片及肾功能。2组病人碎石后均予消炎止血对症治疗2～3d。观察2组病人2周内结石排出情况、复震率，并进行统计处理。结果 实验组51例2周内完全排出者49例（96．08％），部分排出者2例（3．92％），复震者4例（7．8％）；对照组49例2周内完全排出者34例（69．39％），部分排出者15例（30．61％），复震者9例（18．36％）。短时间内实验组的结石排出率明显高于对照组，复震率低于对照组。结论 体外震波碎石配合总攻疗法治疗泌尿系结石具有治疗时间短，结石排出完全，痛苦小，病人可不需住院治疗，总费用低等优点，深受病人欢迎，具有实用性。

Objective To investigate the clinic effect of extracorporeal shock wave lithotripsy （ESWL） combined with general attack therapy. Methods 100 patients with urinary calculi of about 0.8 2.0 cm, but without contraindications, were randomly divided into the experiment group （n= 51） and the control group （n= 49）. The experiment group was administered with general attack therapy based on ESWL while the control group received ESWL alone. All the patients were asked to drink much more water and jump. The efficacy were evaluated 2 weeks later by ultrasonic. Results 49 patients in the experiment group excreted urinary calculi wholly（96.08 % ）, 2 patients excreted partly（3.92 % ）, and 4 patients needed shock again（7.8%）. But in the control group, 34 patients excreted wholly（69.39%）, 15 partly （30.61% ）, and 9 shocked again（ 18.36 % ）. The excretion rate in the experiment group was obviously higher than that in the control group, and the re-shock rate was lower than that in the control group during a shorter time. Conclusions When used in the treatment of urinary calculi, ESWL with general attack therapy has a shorter treatment time, excrete urinary calculi wholly, and has little pains. In addition, the patients do not need to be treated in hospital, and the total expenses are lower. The method is welcomed by the patients really, and has practicability.