输尿管镜钬激光碎石联合排石颗粒治疗输尿管上段结石的临床研究

Clinical Study of Ureteroscopic Holmium Laser Lithotripsy Combined with Paishi Granules in the Treatment of Upper Ureteral Calculi

目的探讨对输尿管上段结石予输尿管镜钬激光碎石术联合排石颗粒治疗的临床效果。方法便利选择该院2018年1月—2021年10月收治的输尿管上段结石患者92例为研究对象,以随机数表法分为对照组(n=46,输尿管镜钬激光碎石术治疗)与观察组(n=46,对照组基础上联合排石颗粒治疗),两组均治疗4周后评价疗效,检测治疗前后血肌酐(Scr)、尿素氮(BUN)水平来评估肾功能,并检测治疗前后C反应蛋白、尿红细胞评分、尿白细胞评分,评估炎症反应状态。结果观察组总有效率(95.65%)高于对照组(80.43%),差异有统计学意义(χ^(2)=5.060,P<0.05)。观察组治疗后Scr、BUN水平分别为(110.17±7.98)μmol/L、(7.43±1.05)mmol/L,均低于对照组(126.59±10.24)μmol/L、(8.33±1.26)mmol/L,差异有统计学意义(t=8.578、3.722,P<0.05)。观察组治疗后C反应蛋白、尿红细胞评分、尿白细胞评分分别为(8.42±3.67)mg/L、(1.32±0.40)分、(1.22±0.42)分,均低于对照组(13.91±4.15)mg/L、(1.76±0.55)分、(2.20±0.71)分,差异有统计学意义(t=6.721、4.388、8.057,P<0.05)。结论对输尿管上段结石者在输尿管镜钬激光碎石治疗基础上联用排石颗粒可提高术后排石效果,有利于患者肾功能的改善,且可减轻机体炎症反应,值得推广。

Objective To investigate the clinical effect of ureteroscopic holmium laser lithotripsy combined with Paishi granules in the treatment of upper ureteral calculi.Methods Conveniently selected 92 patients with upper ureteral calculi admitted to the hospital from January 2018 to October 2021 as the study objects,and they were randomly divided into the control group(n=46,treated with ureteroscopic holmium laser lithotripsy)and the observation group(n=46,treated with paishi granules based on the control group).The efficacy of both groups was evaluated after 4 weeks of treatment.Renal function was assessed by serum creatinine(Scr)and urea nitrogen(BUN)levels before and after treatment,and inflammation was assessed by C-reactive protein,urine red blood cell score and urine white blood cell score before and after treatment.Results The total effective rate in the observation group was 95.65%,higher than 80.43%of the control group,the difference was statistically significant(χ^(2)=5.060,P<0.05).The levels of Scr and BUN in the observation group after treatment were(110.17±7.98)μmol/L and(7.43±1.05)mmol/L,respectively,which were lower than those in the control group(126.59±10.24)μmol/L and(8.33±1.26)mmol/L,the difference was statistically significant(t=8.578,3.722,P<0.05).After treatment,c-reactive protein,urine erythrocyte score and urine leucocyte score in observation group were(8.42±3.67)mg/L,(1.32±0.40)points,(1.22±0.42)points,respectively lower than the control group(13.91±4.15)mg/L,(1.76±0.55)points,(2.20±0.71)points,the difference was statistically significant(t=6.721,4.388,8.057,P<0.05).Conclusion In addition to ureteroscopic holmium laser lithotripsy for patients with upper ureteral calculi,the combined use of baishi granules can improve the postoperative stone removal effect,improve patients'renal function,and reduce the body's inflammatory response,which is worthy of promotion.