双氯酚酸钠配合体外冲击波碎石治疗上尿路结石临床观察

Clinical Observation on Diclophenac Sodium Combined with Extracorporeal Shock Wave Lithotripsy in Treatment of Patients with Calculi in Upper Urinary Tract

目的探讨双氯芬酸钠缓释片配合体外冲击波碎石(ESWL)治疗上尿路结石的临床效果。方法选取2014年6月—2015年12月我院诊断为上尿路结石并行ESWL治疗的165例,采用随机数字表法分为观察组(n=83)和对照组(n=82)。两组均予ESWL治疗,观察组于治疗前1 h予双氯芬酸钠缓释片100 mg,观察两组临床疗效、止痛效果、结石排出和并发症发生情况。结果观察组治疗总有效率(89.2%)明显高于对照组(70.7%),差异有统计学意义(P<0.05);观察组止痛总有效率(92.8%)高于对照组(74.4%),差异有统计学意义(P<0.05);观察组、对照组结石平均排出时间分别为(5.62±1.37)d、(7.94±1.88)d,差异有统计学意义(P<0.05);观察组、对照组结石完全排除率分别为95.2%(79/83)、76.8%(63/82),差异有统计学意义(P<0.05);观察组术后并发症发生率为25.3%,对照组为24.4%,差异无统计学意义(P>0.05)。结论双氯芬酸钠配合ESWL能提高碎石效果,减轻患者疼痛。

Objective To investigate clinical efficacy of Diclophenac Sodium Sustained Release Tablets combined with extracorporeal shock wave lithotripsy（ ESWL） in treatment of patients with calculi in upper urinary tract. Methods A total of 165 patients with calculi in upper urinary tract,who underwent ESWL during June 2014 and December 2015,were divided into observation group（ n = 83） and control group（ n = 82） by random number table method. All patients underwent ESWL,and observation group was treated with Diclophenac Sodium Sustained Release Tablets（ 100 mg） 1 h before ESWL treatment. Clinical efficacy,analgesia effect,lithecbole conditions and incidence rate of complications were observed in two groups. Results The total effective rate in observation group（ 89. 2%） was significantly higher than 70. 7% in control group（ P〈0. 05）. Pain relief rate in observation group（ 92. 8%） was significantly higher than 74. 4% in control group（ P〈0. 05）. The average lithecbole times were（ 5. 62 ± 1. 37） d in observation group and（ 7. 94 ± 1. 88） d in control group,and the difference was statistically significant in the two groups（ P〈0. 05）. Incidence rates of complication were 25. 3% in observation group and 24. 4% in control group,but the difference was not statistically significant in the two groups（ P〈0. 05）.Conclusion Diclophenac Sodium Sustained Release Tablets combined with extracorporeal shock wave lithotripsy may improve clinical efficacy of crushed stone and play good analgesic effect in treatment of patients with calculi in upper urinary tract.