体外冲击波联合输尿管镜下气压弹道碎石治疗输尿管结石的临床效果评价

Evaluation of the Clinical Effect of Extracorporeal Shock Wave Combined with Ureteroscopic Pneumatic Lithotripsy in theTtreatment of Ureteral Calculi

目的探讨体外冲击波联合输尿管镜下气压弹道碎石治疗输尿管结石临床效果评价。方法将2015年5月至2018年12月在我院泌尿外科治疗的86例输尿管结石患者随机分为两组,对照组采用体外冲击波碎石术(ESWL)治疗,观察组采用ESWL联合输尿管镜下气压弹道碎石术(TUL)治疗,比较两组患者的结石清除率、并发症发生率、各项手术指标、肾功能恢复效果。结果观察组上段、中段、下段输尿管结石清除率均明显高于对照组(P<0.05);观察组血尿、腰痛、恶心呕吐、发热等并发症发生率明显低于对照组(P<0.05);观察组手术时间明显长于对照组(P<0.05),术中出血量、住院时间与对照组相比无明显差异(P>0.05);观察组术后血清肌酐水平明显低于对照组,而内生肌酐清除率明显高于对照组(P<0.05)。结论ESWL联合TUL治疗输尿管结石临床效果显著,能有效提高结石清除率,降低术后并发症发生率,促进肾功能的恢复,具有积极的临床意义。

Objective To evaluate the clinical effect of extracorporeal shock wave combined with ureteroscopic pneumatic lithotripsy in the treatment of ureteral calculi.Methods In may 2015-December 2018 in our hospital uropoiesis surgical treatment of 86 patients with ureteral calculi were randomly divided into two groups,control group adopts extracorporeal shock wave lithotripsy(ESWL)treatment,the observation group by ESWL combined under ureteroscopy pneumatic ballistic lithotripsy(TUL)treatment,compared two groups of patients with calculi clearance rate,complication rate,the operation indexes,the effect of renal function recovery.Results The upper,middle and lower ureteral stone clearance rates in the observation group were signifi cantly higher than those in the control group(P<0.05).The incidence of hematuria,low back pain,nausea and vomiting,fever and other complications in the observation group was signifi cantly lower than that in the control group(P<0.05).The operation time of the observation group was signifi cantly longer than that of the control group(P<0.05),and there were no signifi cant differences in intraoperative blood loss and hospital stay between the observation group and the control group(P>0.05).The serum creatinine level in the observation group was signifi cantly lower than that in the control group,and the clearance rate of endogenous creatinine was signifi cantly higher than that in the control group(P<0.05).Conclusion ESWL combined with TUL has a signifi cant clinical effect in the treatment of ureteral calculi,which can effectively improve the stone clearance rate,reduce the incidence of postoperative complications,and promote the recovery of renal function,with positive clinical signifi cance.