体外冲击波碎石术与输尿管镜碎石术治疗输尿管结石的临床效果

Clinical effects of extracorporeal shock wave lithotripsy and ureteroscopic lithotripsy in the treatment of ureteral calculi

目的探究体外冲击波碎石术(ESWL)与输尿管镜碎石术(URL)治疗输尿管结石的临床效果。方法选取我院收治的82例输尿管结石患者作为研究对象,根据治疗方式的不同将其分为对照组与试验组,每组41例。ESWL为对照组治疗方案,URL为试验组治疗方案。对比两组治疗总有效率、结石清除率、手术观察指标、实验室指标、并发症发生率及生活质量评分。结果试验组治疗总有效率显著高于对照组(P=0.0206)。试验组上段结石及中下段结石清除率均显著高于对照组(P<0.05)。试验组手术时间、下床活动时间、住院时间均显著短于对照组(P<0.05)。治疗后,两组NGAL、α1-MG水平均显著升高,且试验组低于对照组(P<0.05)。试验组血尿、结石上移、输尿管穿孔、肾绞痛发生率均显著高于对照组(P<0.05)。治疗后,两组各项生活质量评分均显著升高,且试验组高于对照组(P<0.05)。结论应用ESWL与URL治疗输尿管结石均具有一定的临床效果,后者的治疗总有效率与一次性结石清除率高于前者,但后者并发症较多,故在治疗时,应给予针对性预防措施,提高预后效果。

Objective To explore the clinical effects of extracorporeal shock wave lithotripsy(ESWL) and ureteroscopic lithotripsy(URL) in the treatment of ureteral calculi. Methods Eighty-two patients with ureteral calculi admitted in our hospital were selected as research objects and divided into control group and experimental group according to different treatment methods, with 41 cases in each group. ESWL was the treatment scheme for the control group, and URL was the treatment scheme for the experimental group. The total effective rate of treatment, stone clearance rate, surgical observation indexes, laboratory indexes, complication rate and quality of life scores were compared between the two groups. Results The total effective rate of treatment in the experimental group was significantly higher than that of the control group(P=0.0206).The clearance rates of upper stones and middle and lower stones in the experimental group were significantly higher than those in the control group(P <0.05). The operation time, the time of getting out of bed and the hospital stay in the experimental group were significantly shorter than those in the control group(P<0.05). After treatment, the levels of NGAL and α1-MG in both groups increased significantly, and those in the experimental group were lower than the control group(P <0.05). The incidences of hematuria, stone uplift, ureteral perforation and renal colic in the experimental group were significantly higher than those in the control group(P<0.05). After treatment, the quality of life scores of both groups increased significantly, and those in the experimental group were higher than the control group(P<0.05). Conclusion Both ESWL and URL have certain therapeutic effects in the treatment of ureteral calculi. The latter’s total effective rate of treatment and one-time stone clearance rate are higher than those of the former, but the latter has more complications. In the treatment, targeted preventive measures should be given to improve the prognosis.