急诊输尿管镜治疗输尿管结石并首次肾绞痛的疗效观察

Emergency ureteroscopic lithotomy in treatment of ureteral calculi after first colic attack

目的评价急诊输尿管镜治疗输尿管结石并首次肾绞痛的疗效。方法本院2010年7月至2011年7月期间收治的140例输尿管结石患者纳入本研究范畴,其中60例输尿管结石患者首次肾绞痛时就诊,急诊行输尿管镜钬激光碎石,纳入第一组;80例患者对症处理后立即入院或肾绞痛再次发作入院并常规检查后再行输尿管镜钬激光碎石,纳入第2组。对两组患者的碎石效果、辅助治疗及相关并发症等指标进行比较,行统计学分析,得出结论。结果 140例患者均经输尿管镜检查,第1组结石大小0.80±0.31cm,结石一次性清除率96.67%,无患者因结石疼痛再次就诊;第2组结石大小0.75±0.35cm,结石一次性清除率95.00%,因结石疼痛再次就诊次数2.03±1.85,两组患者无严重并发症发生。结论急诊输尿管镜治疗输尿管结石并首次肾绞痛安全可行,能及时解除疼痛。

Objective To explore the efficacy of ureteroscopic stone treatment immediately after the first colic attack. Methods A total of 140 cases of ureteral stones patients were included into this trial, between July 2010 to July 2011 in our hospital. Sixty patients in group 1 underwent rigid ureteroscopy after the first colic attack. The remaining 80 patients in group 2 were treated with appropriate medical therapy for a period of time for colic pain and subsequently underwent either rigid ureteroscopy or pneumatic lithotripsy in a planned manner. The stone clearance rate, auxiliary treatment, and complications were evaluated between the 2 groups using statistical analysis, then got conclusions. Results All the patients underwent ureteroscopy procedures successfully. The stone size and stone clearance rate was 0.80±0.31 em and 96.67% in group 1, compared with 0.75±0.35 cm and 95% in group 2. The mean readmission amount to the emergency department for the management of second colic attack was 0 in group 1 and 2.03±1.85 in group 2. No patients experienced a major complication. Conclusions Ureteroscopic lithotripsy immediately after the first colic attack in the cases of obstructive ureteral stones was proved to be safe and effective, and relieve acute colic pain with highly efficient clearance of stones.