体外冲击波碎石术联合输尿管镜下气压弹道碎石术治疗输尿管结石的临床效果

Clinical effects of extracorporeal shock wave lithotripsy combined with transurethral lithotomy on ureteral calculi

目的观察体外冲击波碎石术(ESWL)联合输尿管镜下气压弹道碎石术(TUL)治疗输尿管结石的临床效果。方法抽取2018年5月至2020年5月于山西医科大学第一医院交城分院治疗的120例输尿管结石患者,根据随机数字表法分为对照组和观察组,每组60例。对照组采取ESWL治疗,观察组在对照组治疗基础上联合TUL治疗。比较两组患者的结石清除率、并发症、手术指标及术后肾功能指标。结果观察组结石清除率为96.67%(58/60),对照组为76.67%(46/60),两组比较差异有统计学意义(χ^2=10.38,P<0.05)。观察组术后肾绞痛、血尿、发热、恶心呕吐等不良反应发生率均低于对照组(P<0.05)。与对照组比较,观察组手术时间更长,但出血量更少,住院时间更短(P<0.05);且观察组术后内生肌酐清除率更高,血清肌酐水平更低(P<0.05)。结论ESWL及TUL联合治疗输尿管结石可提高结石清除率,减少并发症及肾损伤,缩短康复时间。

Objective To analyze the clinical effects of extracorporeal shock wave lithotripsy(ESWL)combined with transurethral lithotomy(TUL)in the treatment of ureteral calculi.Methods A total of 120 patients with ureteral calculi treated in Jiaocheng Branch of the First Hospital of Shanxi Medical University from May 2018 to May 2020 were selected and divided into control group and observation group by random number table method,with 60 cases in each group.The control group was treated by ESWL,and the observation group was treated by TUL based on the treatment of control group.The stone clearance rate,complication rate,operation indexes and renal function indexes were compared between the two groups.Results The stone removal rate of the observation group was 96.67%(58/60),and that of the control group was 76.67%(46/60),and the difference was significant(χ^2=10.38,P<0.05).The rates of postoperative complication,including renal colic,blood urine,fever,nausea and vomiting,of the observation group were lower than those of the control group(P<0.05).Compared to the control group,the operation duration of the observation group was longer,the blood loss was less,and hospital stay was shorter(P<0.05).Moreover,the observation group had higher level of endogenous creatinine and lower level of serum creatinine,compared to the control group(P<0.05).Conclusions ESWL combined with TUL can improve the stone clearance rate,reduce complications and renal injury,and shorten the recovery time.