体外冲击波碎石术治疗马蹄肾结石的临床疗效观察

Observation of clinical effect by extracorporeal shock wave lithotripsy in the treatment of horseshoe kidney calculus

目的探讨体外冲击波碎石术应用于马蹄肾结石患者的治疗效果以获得可靠数据为后续研究提供重要的理论依据。方法 40例马蹄肾结石患者作为研究对象,按随机化原则将其分为碎石组(采用体外冲击波碎石术治疗)和排石组(采用排石通淋口服液治疗),每组20例,观察两组治疗效果、治疗后并发症以及治疗后生活质量。结果治疗后碎石组显效13例,有效5例,无效2例,总有效率为90.00%;排石组显效5例,有效6例,无效9例,总有效率为55.00%;碎石组总有效率高于排石组,差异具有统计学意义(χ2=6.14,P<0.05)。经过比较发现,碎石组血尿发生率10.0%、腰腹部疼痛发生率10.0%与排石组的15.0%、10.0%比较差异无统计学意义(χ2=0.23、0,P>0.05),但碎石组出现残留结石率15.0%显著低于排石组45.0%(χ2=4.29,P<0.05)。通过对两组患者进行治疗后6个月生活质量调查可知,碎石组患者自理能力(29.3±3.5)分、活动能力(26.7±4.4)分、精神状态(27.2±2.7)分、睡眠质量(24.5±4.3)分均优于排石组的(22.2±5.8)、(20.5±3.9)、(21.9±9.4)、(19.4±5.8)分,差异均具有统计学意义(P<0.05)。结论体外冲击波碎石技术应用于马蹄肾结石效果较好,能够克服马蹄肾先天结构的特殊性,值得推广。

Objective To investigate curative effect by extracorporeal shock wave lithotripsy applied in the treatment of horseshoe kidney calculus, in order to provide creditable data for further research as theoretical basis. Methods A total of 40 patients with horseshoe kidney calculus as study subjects were randomly divided into lithotripsy group （received extracorporeal shock wave lithotripsy for treatment） and lithagogue group （received Paishi Tonglin oral liquid for treatment）, with 20 cases in each group. Observation was made on curative effects complications in treatment and quality of life after treatment in both groups. Results After treatment, the lithotripsy group had 13 excellent cases, 5 effective cases and 2 ineffective cases, with total effective rate as 90.00%. The lithagogue group had 5 excellent cases, 6 effective cases and 9 ineffective cases, with total effective rate as 55：00%. The lithotripsy group had higher total effective rate than the lithagogue group, and the difference had statistical significance （X2=6.14, P〈0.05）. Comparison of incidences of hematuresis and abdominal pain between the lithotripsy group as 10.0%, 10.0% and the lithagogue group as 15.0%, 10.0% showed no statistically significant difference （X2=0.23, 0, P〉0.05）, while the lithotripsy group had much lower incidence of residual calculus as 15.0% than 45.0% of the lithagogue group （X2=4.29, P〈0.05）. Quality of life investigation in 6 months after treatment showed all better self-care ability as （29.3 ± 3.5） points, mobility as （26.7 ± 4.4） points, psychosis as （27.2 ± 2.7） points and quality of sleep as （24.5 ± 4.3） points in the lithotripsy group than （22.2 ± 5.8）, （20.5 ± 3.9）, （21.9 ± 9.4）, and （19.4 ± 5.8） points in the lithagogue group. Their differences all had statistical significance （P〈O.05）. Conclusion Application of extracorporeal shock wave lithotripsy contains excellent effect for horseshoe kidney calculus. This method can overcome the difficulty of particular innate structure in horseshoe kidney, and it is worth promoting.