体外冲击波碎石术急诊治疗输尿管结石致肾绞痛的临床研究

Clinical Study on the Treatment of Ureteral Calculi with Renal Colic by ESWL

目的探讨体外冲击波碎石术(ESWL)急诊治疗输尿管结石致肾绞痛的有效性与安全性。方法将180例输尿管结石致肾绞痛患者分为两组:观察组82例予急诊ESWL治疗;对照组98例先予解痉镇痛,2～3W后再行ESWL。比较两组的ESWL成功率、术后4W无石率、主要并发症的发生率等临床资料。结果观察组ESWL一次成功率明显高于对照组(P<0.01),但两组总有效率无统计学差异(P>0.05),观察组术后4W无石率高于对照组(P<0.05)。观察组术后出现腰腹部疼痛伴恶心呕吐的发生率低于对照组(P<0.05),但两组术后出现肉眼血尿、发热等并发症的发生率无统计学差异(P>0.05)。结论 ESWL急诊治疗输尿管结石致肾绞痛的疗效显著、术后4W无石率高。

Objective To study the efficacy and safety of extracorporeal shock wave lithotripsy （ESWL） in the emergency treatment of renal colic induced by ureteral calculi. Methods 180 cases with renal colic induced by ureteral calculi were divided into two groups. 82 cases of the observation group were treated by emergency ESWL; 98 cases of control group received ESWL 2 - 3 W after antispasmodic and analgesic therapy. The successful rate of ESWL, non-stone rate 4 W after ESWL, and the incidence of main complications of the two groups were compared. Results The one-time ESWL success rate of observation group was higher than that of the control group （P〈0.01）, but the total efficiency after ESWL were not significantly different between the two groups （P〉O.05）. In the observation group, the non-stone rate 4 W after ESWL was significantly higher than that in the control group （P〈0.05）. The incidence rate of waist and abdomen pain with nausea and vomiting in observation group was significantly lower than that of the control group （P 〈0.05）, but there was no significant difference between two groups in the incidence of other main complications such as hematuria and fever （P 〉0.05）. Conclusions Emergency ESWL for renal colic induced by ureteral calculi is effective and safe, and the non-stone rate 4 W after ESWL was high.