分析不同超声定位方法在单发上尿路结石体外冲击波碎石中的应用效果

Analysis of the Application Effects of Different Ultrasound Positioning Methods in the Treatment of Single Upper Urinary Tract Stones with Extracorporeal Shock Wave Lithotripsy

目的对比经背侧与经腰侧超声定位对单发上尿路结石体外冲击波碎石术结石定位准确性及碎石效果。方法便利选取2018年4月—2020年3月该院门诊治疗的单发上尿路结石患者180例,根据抽签法将所有患者分为背侧组与腰侧组,各90例,背侧组患者采取经背侧超声定位,腰侧组患者采取经腰侧超声定位。对比两组患者在碎石后的疼痛程度、结石定位时间、结石距皮肤距离、碎石成功率及术后1、2周结石排净情况、冲击次数、术中耐受情况。结果背侧组患者的结石定位时间、结石距皮肤距离分别为(6.46±2.08)min、(4.06±0.88)cm明显低于腰侧组,差异有统计学意义(t=18.192、24.725,P<0.05);背侧组患者的结石1次碎石成功率、术后1周、术后2周结石排净率分别为78.89%、86.67%、94.44%均显著高于腰侧组,差异有统计学意义(χ^(2)=5.389、9.284、8.837,P<0.05);背侧组治疗次数及术中不适与腰侧组差异有统计学意义(P<0.05);两组视觉模拟评分法(VAS)评分、并发症对比差异无统计学意义(P>0.05)。结论经背侧超声定位可提高上尿路结石排净率,降低结石定位时间,减少冲击次数,不受肠道影响、患者术中呼吸受限等。

Objective To compare of the accuracy and the effect of ultrasound positioning on single upper urinary tract stones with extracorporeal shock wave lithotripsy via dorsal and lumbar ultrasound positioning.Methods It is convenient to select 180 patients with single upper urinary tract stones treated in the hospital from April 2018 to March 2020 were collected.According to the lottery method,all patients were divided into dorsal group and lumbar group,90 cases in each group,patients in the lumbar group were positioned by dorsal ultrasound,and the patients in the lumbar group were positioned by translumbar ultrasound.The pain degree,stone location time,distance between the stone and the skin,the success rate of the stone after lithotripsy,the number of impacts,and the tolerance during the operation were compared between the two groups of patients.Results The stone location time and the distance between the stones and the skin of the dorsal group were(6.46±2.08)min and(4.06±0.88)cm,respectively,significantly lower than those of the lumbar group,and the difference was statistically significant(t=18.192,24.725,P<0.05).The success rate of 1 stone lithotripsy,the rate of stone removal at 1 week and 2 weeks after the operation of the dorsal group were 78.89%,86.67%and 94.44%,respectively,which were significantly higher than the relevant data of the lumbar group,and the difference was statistically significant(χ^(2)=5.389,9.284,8.837,P<0.05);the number of treatments and intraoperative discomfort in the dorsal group was statistically significantly different from that of the lumbar group(P<0.05);the difference in Visual Analog Scoring(VAS)scores and complications between the two groups was not statistically significant(P>0.05).Conclusion The dorsal ultrasound positioning can increase the rate of upper urinary tract stone elimination,reduce the stone positioning time,reduce the number of impacts,and is not affected by the intestinal tract,and the patient’s breathing is restricted during the operation.