间苯三酚联合坦索罗辛对一期输尿管软镜治疗输尿管上段结石的影响

Influence of Phloroglucinol Combined with Tamsulosin on Upper Ureteral Calculi with One-stage Flexible Ureteroscopy

目的:探讨间苯三酚联合坦索罗辛对一期输尿管软镜治疗输尿管上段结石术中术后并发症、住院天数及医疗费用方面的影响。方法:回顾性分析福建医科大学附属福州市第一医院2020年1月-2022年4月收治的119例年龄20~60岁的输尿管上段结石患者的临床资料,根据围手术期治疗方法分组,其中采用静脉滴注林格氏液治疗的为对照组(52例),采用静脉滴注间苯三酚联合口服坦索罗辛治疗的为观察组(67例),比较两组在一期输尿管软镜钬激光碎石取石术中进镜及置鞘的难易度、输尿管壁损伤程度、术后血尿持续时间、膀胱刺激征、手术时间、住院天数、医疗费用等方面中的不同。结果:观察组术中进输尿管硬镜及输尿管导引鞘困难率、术后并发膀胱刺激征发生率均低于对照组(P<0.05)。两组术中输尿管壁损伤及术后并发血尿持续时间比较,差异均无统计学意义(P>0.05)。观察组手术时间、住院时间均短于对照组,医疗费用少于对照组(P<0.05)。结论:在一期行输尿管软镜钬激光碎石取石术的围手术期,使用间苯三酚及坦索罗辛可以降低术中进镜及置鞘的难度,减少术后膀胱刺激征的发生,同时可以减少手术时间、住院天数,降低医疗费用。

Objective:To investigate the effect of Phloroglucinol combined with Tamsulosin on the intraoperative and postoperative complications,length of hospital stay and medical expenses in the treatment of upper ureteral calculi with one-stage flexible ureteroscopy.Method:The clinical data of 119 patients with upper ureteral calculi aged 20-60 in Affiliated Fuzhou First Hospital of Fujian Medical University from January 2020 to April 2022 were retrospectively analyzed.Patients were divided into two groups according to the perioperative treatment methods,the control group(52 cases)was treated with intravenous infusion Ringer’s Solution,and the observation group(67 cases)was treated with intravenous infusion Phloroglucine combined with oral Tamsulosin.The two groups were compared in terms of difficulty of inserting the mirror and sheath during the first-stage flexible ureteroscope holmium laser lithotripsy,ureteral wall damage,postoperative hematuria duration and bladder irritation,operation time,length of hospital stay and medical expenses between the two groups.Result:The difficulty rate of intraoperative ureteroscope and ureteral introducer sheath placement,the incidence of postoperative bladder irritation symptoms in the observation group were less than those in the control group(P<0.05).There were no significant differences in the incidence of intraoperative ureteral injury and postoperative hematuria duration between the two groups(P>0.05).The operation time and hospitalization time of the observation group were shorter than those of the control group,and the medical expenses were less than that of the control group(P<0.05).Conclusion:In the perioperative period of one-stage flexible ureteroscope holmium laser lithotripsy,the use of Phloroglucinol and Tamsulosin can reduce the difficulty of intraoperative endoscopic/sheathing,reduce postoperative bladder irritation,and reduce the operation time,hospital days and medical expenses of patients.