以尿常规检查为主的诊治方案对急性输尿管结石的作用

Study on the Effect of Diagnosis and Treatment Method Based on Routine Urine Examination on Acute Ureteral Calculi

目的探讨以尿常规检查为主的快速诊治方案对急性输尿管结石的作用。方法选择2008年1月至2012年12月在安丘市人民医院就诊的500例输尿管结石疑诊患者作为研究对象,根据诊疗方法分为快速组(400例)和一般诊疗组(100例)。快速组先行尿常规检查,若为血尿则初诊为输尿管结石,迅速给予盐酸哌替啶镇痛,疼痛减轻后行超声检查,确诊后行排石治疗;对照组行泌尿系统超声检查确诊后给予止痛及排石治疗。比较两组患者止痛药物的应用时间、疼痛缓解或消失时间,第1、3、7日结石排出情况,患者的满意度。结果快速组止痛药应用时间要显著短于一般诊疗组[(15±8)min比(30±20)min,P<0.01],其疼痛消失或减轻时间也显著短于一般诊疗组[(40±15)min比(60±37)min,P<0.01],患者的满意率明显高于一般诊疗组(95.0%比83.0%,P<0.01),但其结石的排出情况比较差异无统计学意义(P>0.05)。结论以尿常规检查为主的快速诊治方案效果确切,能快速减轻患者的痛苦,且不影响患者最后的排石效果。

Objective To investigate a method for rapid diagnosis and timely treatment of ureteral cal-culi.Methods A total of 500 cases of acute ureteral calculi admitted in Anqiu People′s Hospital from Jan. 2008 to Dec.2012 were selected and divided into rapid diagnosis and treatment group（400 cases）（rapid group）,and general diagnosis and treatment group（100 cases） （general group）.Patients in the rapid group first received urine routine test,if it showed hematuria,the patients can be primarily diagnosed as ureteral calculi,and were quickly given pethidine hydrochloride 100 mg,IM,B-ultrasound examination was conducted after the pain alleviated,and removal of the ureteral calculi was operated after final diagnosis.Patients in the general group first underwent ureter B-ultrasound examination,and then analgesia treatment and removal of the ureteral calculi were conducted after diagnosis.Application time of analgesic drug,time of pain relief and disappearance,the calculi discharging rates on the 1st,3rd and 7th day after treatment,as well as the satisfac-tion rates of the two groups were compared.Results Application time of analgesic drug In the rapid group, was significantly shorter than that of the general group[（15 ±8） min vs （30 ±20） min,P 〈0.01];and time of pain relief and disappearance was also significantly less than the general group [ （ 40 ±15 ） min vs （60 ±37） min,P〈0.01];satisfaction rate was significantly higher than that of the general group （95.0%vs 83.0%,P 〈0.01）;while the calculi discharging rate of the two groups had no statistically significant difference（P〉0.05）.Conclusion Rapid diagnosis and treatment method for ureteral calculi has definite effect,it can rapidly reduce the pain of the patients,and has no impact on the calculi discharging.