经尿道腔镜下取石术治疗输尿管结石伴肾积水的疗效观察

Clinical effect of endoscopic transurethral lithotripsy in the treatment of ureteral calculus complicated with hydronephrosis

目的探究经尿道腔镜下取石术治疗输尿管结石伴肾积水的疗效。方法以2015年1月~2016年5月纳入的90例输尿管结石伴肾积水患者为研究对象。将45例患者采取经腹腔镜输尿管切开取石术作为对照组,另45例患者行经尿道腔镜下取石术作为观察组。比较两组术后第3天血浆C反应蛋白(CRP)水平、术后血尿持续时间,比较两组碎石成功率(术后3个月B超显示结石排净)以及术中并发症发生情况。结果对照组患者术后的CRP水平为(38.74±5.45)mg/L,血尿时间为(6.10±1.52)d;观察组术后CRP水平为(32.41±4.97)mg/L,血尿时间为(4.14±1.13)d,组间比较对照组术后CRP水平及血尿时间均高于观察组,差异有统计学意义(P<0.05)。对照组碎石成功率为100.0%,观察组为93.3%,两组碎石成功率比较差异无统计学意义(P>0.05);观察组共发生并发症4例,对照组则有17例,对比组间发现观察组并发症发生率明显比对照组低,差别有统计学意义(P<0.05)。结论采用经尿道腔镜下取石术治疗输尿管结石伴肾积水,具有疗效佳、损伤小等特点,且操作方便,可于临床进行推广。

Objective To explore the clinical effect of endoscopic transurethra[ lithotripsy in the treatment of ureteral calculus complicated with hydronephrosis. Methods 90 ureteral calculus patients complicated with hydronephrosis treated from January 2015 to May 2016 in our hospital were selected. The control group adopted the laparoseopie uretemlithotomy;the observation group adopted the endoscopic transurethral lithotomy. After 3 days of surgery, the CRP level, duration of hematuresis, removal success rate （After 3 months, B ultrasound displayed that the calculus was completely emptied） and incidence rate of postoperative complications for two groups were compared. Results After surgery, the CRP level and duration of hematuresis for control group was （38.74 ~ 5.45 ） mg/L and （6.10＋-- 1.52） d; the CRP level and duration of hematuresis for observation group was （32.41 ＋-4.97） mg/L and （4.14~ 1.13） d （P 〈 0.05） ; the removal success rate for control group and observation group was 100.0% and 93.3% （P 〉 0.05） ; The incidence rate of complications for observation group （4 cases） was significandy lower than control group （ 17 eases） （P 〈 0.05 ）. Conclusion For ureteral calculus patients complicated with hydronephrosis, the endoscopic transurethral lithotripsy is easy to operate, improves the clinical effect and reduces the clinical trauma. It is worthy of clinical promotion.