体外冲击波与内镜手术治疗泌尿系结石的效果

Effect of extracorporeal shock wave and endoscopic surgery on urinary calculi

目的:分析对比泌尿系结石患者采用体外冲击波与内镜手术进行治疗的临床效果,为临床后续诊疗提供参考借鉴。方法:本研究始于2017年12月,截至2018年8月,以此期间的82例泌尿系结石患者作为本次研究的观察对象,根据随机、单盲的方法将此82例患者分成内镜组和冲击波组,在分组基础上采用不同方法进行治疗并对比分析治疗效果及安全性。结果:内镜组患者的下床活动时间及住院时间更短,术后VAS评分更低,两组比较差异有统计学意义(P<0.05),说明内镜治疗的效果更优,疼痛感更低;0.6~1cm肾结石、0.6~1.5cm且嵌顿<1月患者的输尿管结石清除率差异无统计学意义(P>0.05),1.0~2.0cm肾结石、0.6~1.5cm且嵌顿>1个月、1.5~2.0cm输尿管结石组患者结石清除率有差异(P<0.05),内镜组清除率显著高于冲击波组;两组患者肉眼血尿、严重感染及血肿并发症的发生率差异无统计学意义(P>0.05),冲击波组患者的术后疼痛发生率显著高于内镜组,两组比较差异有统计学意义(P<0.05)。结论:内镜碎石的临床效果更加安全有效,疼痛度更低,更利于患者康复,值得推广应用。

Objective:To analyze and compare the clinical effects of extracorporeal shock wave and endoscopic surgery on patients with urinary calculi,so as to provide reference for subsequent clinical diagnosis and treatment.Methods:This study began in December 2017 and ended in August 2018.82 patients with urinary calculi during this period were taken as the observation subjects of this study. According to the random,single-blind method,82 patients were divided into the endoscopic group and the shockwave group.On the basis of grouping,different methods were used for treatment and the efficacy and safety of treatment were compared.Result:Patients in the endoscopic group had shorter time to get out of bed and stay in hospital,and lower postoperative VAS score.The difference between the two groups was statistically significant (P<0.05),indicating that endoscopic treatment had better effect and lower pain.The clearance rate of ureteral calculi in patients with 0.6 ~ 1cm renal calculi,0.6 ~ 1.5cm renal calculi and incarceration <1 month was not significantly different (P>0.05).The clearance rate of ureteral calculi in patients with 1 ~ 2cm renal calculi,0.6 ~ 1.5cm renal calculi and incarceration > for 1 month and 1.5 ~ 2cm ureteral calculi in the endoscopic group was significantly higher than that in the shockwave group (P<0.05). There was no significant difference in the incidence of macroscopic hematuria,severe infection and hematoma complications between the two groups (P>0.05),and the incidence of postoperative pain in the shockwave group was significantly higher than that in the endoscopic group,which was with statistically significant difference between the two groups (P<0.05).Conclusion:Endoscopic lithotripsy had safer and more effective clinical effects,lower pain,and was more conducive to the rehabilitation of patients,which was worthy of promotion and application.