输尿管镜下钬激光碎石术联合坦索罗辛治疗输尿管结石的疗效分析

Efficacy analysis of ureteroscopic holmium laser lithotripsy combined with tamsulosin in the treatment of ureteral calculi

目的分析输尿管镜下钬激光碎石术联合坦索罗辛治疗输尿管结石的临床疗效。方法74例输尿管结石患者,按随机数字表法分为对照组和观察组,各37例。对照组实施输尿管镜下钬激光碎石术治疗,观察组实施输尿管镜下钬激光碎石术联合坦索罗辛治疗。比较两组患者一次性置镜成功率、术后住院时间、术后结石排净率、术后并发症发生率、术后第14天输尿管支架管相关症状问卷(USSQ)评分及复发率。结果观察组一次性置镜成功率100.00%(37/37)明显高于对照组的75.68%(28/37),术后住院时间(2.58±0.45)d明显短于对照组的(3.60±0.48)d,差异有统计学意义(P<0.05)。观察组术后7、14、21、28 d结石排净率分别为67.57%、83.78%、89.19%、97.30%,明显高于对照组的40.54%、51.35%、59.46%、67.57%,差异有统计学意义(P<0.05)。观察组肾绞痛、尿路感染发生率分别为29.73%、5.41%,明显低于对照组的56.76%、21.62%,差异有统计学意义(P<0.05)。观察组术后第14天尿路症状评分(13.70±5.48)分、躯体疼痛症状评分(9.44±3.52)分、整体健康状况评分(7.28±2.55)分明显低于对照组的(25.56±8.05)、(17.84±6.45)、(13.12±4.20)分,差异有统计学意义(P<0.05)。观察组复发率0低于对照组的16.22%,差异有统计学意义(P<0.05)。结论输尿管镜下钬激光碎石术联合坦索罗辛治疗输尿管结石有助于提高术中一次性置镜成功率,缩短住院时间,降低术后并发症发生率及结石复发率,减轻输尿管支架管相关症状,提高结石排净率。

Objective To analyze the clinical efficacy of ureteroscopic holmium laser lithotripsy combined with tamsulosin in the treatment of ureteral calculi.Methods A total of 74 patients with ureteral calculi were divided into control group and observation group according to random numerical table,with 37 cases in each group.The control group was treated with ureteroscopic holmium laser lithotripsy,and the observation group was treated with ureteroscopic holmium laser lithotripsy and tamsulosin.Both groups were compared in terms of success rate of one-time endoscopic placement,postoperative hospitalization time,postoperative calculi removal rate,postoperative complication rate,the score of ureteral stent symptoms questionnaire(USSQ)on the 14th day after surgery,and recurrence rate.Results The success rate of one-time endoscopic placement in the observation group was 100.00%(37/37),which was significantly higher than that of 75.68%(28/37)in the control group;the postoperative hospitalization time of(2.58±0.45)d in the observation group was significantly shorter than that of(3.60±0.48)d in the control group;the differences were statistically significant(P<0.05).The calculi removal rates were 67.57%,83.78%,89.19% and 97.30%7,14,21 and 28 d after surgery in the observation group,which were significantly higher than those of 40.54%,51.35%,59.46% and 67.57% in the control group,and the differences were statistically significant(P<0.05).The incidence rates of renal colic and urinary tract infection in the observation group were 29.73% and 5.41%,which were significantly lower than those of 56.76% and 21.62% in the control group,and the differences were statistically significant(P<0.05).The observation group had urinary tract symptom score of(13.70±5.48)points,somatic pain symptom score of(9.44±3.52)points and overall health status score of(7.28±2.55)points on the 14th day after surgery,which were significantly lower than those of(25.56±8.05),(17.84±6.45)and(13.12±4.20)points in the control group,and the differences were statistically significant(P<0.05).The recurrence rate of the observation group was 0,which was lower than that of 16.22% of the control group,and the difference was statistically significant(P<0.05).Conclusion The combined application of ureteroscopic holmium laser lithotripsy and tamsulossine can improve the success rate of one-time endoscopic placement,shorten the hospitalization time,reduce the incidence of postoperative complications and recurrence rate,relieve ureteral stent symptoms,and improve the calculi removal rate.