输尿管镜下钬激光碎石联合排石汤治疗输尿管结石临床研究

The Clinical Research into Ureteral Calculi Treated with Holmium Laser Lithotripsy Under the Ureter Mirror in Combination with Pai Shi Decoction

目的:观察自拟排石汤联合输尿管镜下钬激光碎石治疗输尿管结石的临床疗效。方法:将120例确诊为输尿管结石患者行输尿管镜下钬激光碎石,术后常规予以西药抗感染、解痉、止痛等对症处理,并随机分成3组,每组40例,A组采用排石汤治疗,每次100 m L,日2次,共服2周;B组每天睡前口服α-受体阻滞剂盐酸坦洛新胶囊,每粒0.2 mg,每次2粒,每日3次;C组术后常规处理,嘱多饮水、多运动,每日尿量大于2 500 m L。所有患者观察终点为4周,记录患者下尿路刺激症、肉眼血尿、尿路感染、腰痛或下腹痛等情况,每周复查B超,第1周、第4周增加尿路平片。结果:1周后A组、B组、C组结石清除率分别为72.5%、50.0%、45.0%,其中A组的结石清除率显著高于B组、C组。从排石时间看,A组也要快于B组、C组,而2周、3周、4周结石清除率并没有统计学差异。A组术后4周尿路刺激症、肉眼血尿、尿路感染、腰痛或下腹痛症状较B组、C组明显减少(P<0.05),有统计学意义。结论:输尿管镜下钬激光碎石术后运用中药排石汤剂治疗可以明显提高输尿管结石清除率,提高排石速率,缓解下尿路刺激症症状、腰痛等不适症状。

Objective： To observe the clinical curative effect of self-designed Pal Shi Decoction （PSD） in combination with Ilolmi- um laser lithotripsy under the ureter mirror. Methods： One hundred and twenty patients who were diagnosed as ureteral calculi were treated with hohnium laser lithotripsy under the ureter mirror. After operation, they were given routine Western medicine for anti-infection, spasmolysis and analgesia. The patients were randomly divided into 3 groups, with 40 cases in eacil group. The ones in Group A were treated with PSD, 100ml each time, twice a day, for 2 weeks. The ones in Group B took a receptor blockcr tamsulnsin hydrochloride capsules for oral administration before sleep, 0. 2mg/granule, 2 granules each time, three times each day, The ones in Group C were treated with conventional treatment, drink more water, do more exercise, and their daily urine volume is more than 2500 ml. All the patients were observed for 4 weeks. Their LUST, hematuria, urinary, tract infection, low back pain or lower abdominal pain were recorded. They were given a B-mode uhrasonography each week. On the 1st week and 4th week, Nianluping tablets （NLPT） were added. Results： After one week＇s treatment, the stone clearance rates of Grnup A, B, C were 72.5% , 50% , 45% respectively. Group A was signific, antly higher than Group B and Group C. From the stune ex- pulsion time, Group A was faster than Group B and Group C. The stone clearance rates on the 2nd week, the 3rd week, and 4th week had no statistical significance. Four weeks later after the operation, Group A＇s I,UST, hematuria, urinat7 tract infer.lion, low back pain or lower abdominal pain were obviously reduced compared with Group B and Croup C （ P 〈 0.05 ） , and . the differences between them had statistical significance. Conclusion： Holmium laser lithotripsy under the ureter mirror in combina- tion with PSD can significantly improve the clearance rate of ureteral calculi, enhance the rate of stone removal, relieve symptoms such as LUST symptoms and low hack pain.