输尿管镜碎石术联合体外冲击波碎石治疗较大肾盂结石临床研究

Clinical studies of treating larger renal pelvis stones with ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy

目的:分析并讨论输尿管镜碎石术联合体外冲击波碎石治疗较大肾盂结石的结果及其是否出现并发症。方法:选取2010年9月至2012年9月我院收治的肾盂结石的患者90例作为研究对象。随机分为选用输尿管镜碎石术联合体外冲击波碎石治疗的观察组和只选用输尿管镜碎石术治疗的对照组。两组患者均采用常规止痛、解痉、补液、抗炎等治疗,在进行碎石术治疗后的七天后观察患者的临床症状作出疗效判断。比较两组患者的疗效。结果:治疗后,两组患者的结石均有排出,但是观察组与对照组有明显差异,观察组的成功排石人数比对照组高26.78%,P<0.05,具有统计学意义。部分患者在治疗的过程中出现了一系列并发症,涉及全身多个系统,最典型的有血尿,肾绞痛,消化道出血等情况产生,其中对照组的并发症明显多于观察组,对照组的并发症发生率比观察组高31.11%,两组比较差异明显,P<0.05,具有统计学意义。结论:输尿管镜碎石术联合体外冲击波碎石治疗较大肾盂结石相较于传统的开放式治疗方法有良好的效果,患者普遍满意,虽然花费相对较高,但是痛苦少,副作用小,感染率小,无创伤,还是值得在临床上广泛推广。

Objective：To analyze and discuss the results and complications of treating larger renal pelvis stones with ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy. Methods： From 9. 2010. to 9. 2012, 90 cases of the patients with renal pelvis stones in our hospital were chosen as the study objects They were divided into randomly ：the observation group given the ureteroscopic lithotripsy combined with extracorporeal shock wave lithotripsyand and the control group with the ureteroscopic lithotripsy treatment. The two groups were treated with conventional analgesic, antispasmodic, rehydration, anti-inflammatory therapy. And the clinical symptoms seven days after the treatment were observed and jusged. The effects of the two groups were compared. Results： After the treatment, two groups both had discharged stones, but the observation group had the obvious differences with the control group, P 〈 0.05, it has statistical significance. A series of complications happened to some patients during the treatment process, involving multiple body system, the most typical of which were hematuria, renal colic, gastrointestinal bleeding. The complications in the control group were obviously more than the observation group by 31.11% ; there were significant differences between the two groups, P 〈 0.05, it has statistical significance. Conclusions： It has good effects to treat larger renal pelvis stones with ureteroscopic lithotripsy and extracorporeal shock wave lithotripsy compared with the traditional open methods, and patients were generally satisfied . Although the cost is relatively high, but it has less pain , fewer side effects, amll infection rate, no trauma and whicha is worthy of popularization in clinic.