肾结石ESWL治疗前置入双J管的临床探讨

Clinical Study of ESWL for Kidney Stones Treated with Double J Tube

目的评估在肾脏1.5~2.0 cm结石ESWL治疗前置入双J管的效果。方法2018年1月—2019年7月方便选取90例患者,分为两组,治疗组40例患者在ESWL治疗前置入双J管,对照组50例患者无支架行ESWL治疗。在ESWL后第3、7、14、28、42、60和90天进行随访,统计关于疼痛、住院治疗和经尿道结石排出的情况,以及发生泌尿道梗阻肾积水的情况。结果在治疗组患者碎石后均未发生输尿管梗阻,结石顺利排除,只有12例患者发生轻度疼痛。在对照组中20例患者发生了需要到医院治疗的严重肾绞痛等并发症,30例患者出现了由于石街导致的需要用口服或肌注止痛药的轻到中度疼痛。治疗组疼痛发生率30%明显低于对照组100%,两组患者不同程度疼痛的发生率比较(χ^2=50.806,P<0.05)。治疗组结石完全排除时间延长,两组患者结石完全排除率比较差异有统计学意义(P<0.05)。结论肾脏结石较大的患者,在接受ESWL碎石前,为避免剧烈的肾绞痛,双J管应该提前置入。

Objective To evaluate the effect of ESWL treatment on 1.5-2.0cm kidney stones before double-J tube insertion.Methods From January 2018 to July 2019,90 patients were convenient selected and divided into two groups.40 patients in the treatment group received double J tubes before ESWL treatment,and 50 patients in the control group received ESWL without stent.Follow-up was performed on days 3,7,14,28,42,60,and 90 after ESWL,and statistics were collected on pain,hospitalization,and urethral stone discharge,as well as the occurrence of urinary tract obstruction and hydronephrosis.Results No ureteral obstruction occurred in the treatment group after lithotripsy,stones were successfully ruled out,and only 12 patients experienced mild pain.In the control group,20 patients experienced complications such as severe renal colic that required hospital treatment,and 30 patients experienced mild to moderate pain due to stone streets requiring oral or intramuscular painkillers.The incidence of pain in the treatment group was significantly lower than that in the control group at 30%,lower than the control group 100%.The incidence of pain in different degrees in the two groups was significantly significant(χ^2=50.806,P<0.05).The complete elimination of stones was prolonged in the treatment group,and the rate of complete elimination of stones in the two groups of patients was significantly significant(P<0.05).Conclusion Before receiving ESWL lithotripsy,to avoid severe renal colic in patients with large kidney stones,double J tubes should be placed in advance.