输尿管镜治疗输尿管结石并绞痛临床疗效分析

Clinical effect analysis of ureteroscope in treating ureteral calculus and colic

目的:探讨输尿管镜治疗输尿管结石并绞痛临床疗效。方法:纳入2012年1月—2015年7月输尿管结石并绞痛患者80例,随机分组方法:随机数字表法,分为两组,输尿管镜组和冲击波组,每组40例。冲击波组行体外冲击波碎石治疗;观察行输尿管镜钬激光碎石治疗。对比两组患者手术平均耗时和碎石成功率、疼痛缓解率、术后4周结石排净率、术后并发症率。结果:输尿管镜组患者手术平均耗时稍短于冲击波组,并发症相似,差异不显著(P>0.05)。输尿管镜组碎石成功率高于冲击波组,经x2检验统计学处理显示差异显著(P<0.05)。对于直径≤10 mm的输尿管结石,两组疼痛缓解率、术后4周结石排净率无显著差异(P>0.05)。对于直径>10 mm的输尿管结石,输尿管镜组疼痛缓解率、术后4周结石排净率高于冲击波组,经x2检验统计学处理显示差异显著(P<0.05)。结论:输尿管镜治疗输尿管结石并绞痛临床疗效确切,碎石成功率明显高于体外冲击波碎石,且对于体积较大的结石可有效提高结石排净率和缓解患者疼痛,值得推广。

Objective: To explore the clinical effect of ureteroscope in treating ureteral calculus and colic. Methods: 80 patients withureteral calculus and colic, treated in our hospital from January 2012 to July 2015, were randomly divided into two groups, 40 cases in theureteroscope group received holmium laser ureterolithotripsy, 40 cases in the impact wave group received extracorporeal shock wavelithotripsy. The average time of operation and success rate of lithotripsy, the rate of pain relief, the ureteral calculus drainage rate after 4weeks, the rate of postoperative complications of patients in two groups were compared. Results: The average time of operation of the ureteroscope group was slightly shorter than that of the impact wave group, while the complications were similar, the difference was notstatistically significant (P>0.05). The success rate of lithotripsy of the ureteroscope group was higher than that of the impact wave group,the difference was statistically significant by x2 test (P<0.05). For ureteral calculi of which the diameter was≤10mm, the difference of therate of pain relief and the ureteral calculus drainage rate after 4 weeks of two groups was not statistically significant (P>0.05). For ureteralcalculi of which the diameter was>10mm, the rate of pain relief and the ureteral calculus drainage rate after 4 weeks of the ureteroscopegroup was higher than that of the impact wave group, the difference was statistically significant by x2 test (P<0.05). Conclusion:Ureteroscope had significant clinical effect in treating ureteral calculus and colic, the success rate of lithotripsy was significantly higherthan that of the impact wave, and it could effectively improve the ureteral calculus drainage rate after 4 weeks and the rate of pain relief ofpatients with bigger ureteral calculus, therefore, it was worthy of promotion.