体外冲击波碎石术治疗输尿管结石后短期内行输尿管镜下气压弹道碎石术治疗的疗效分析

Analysis of the curative effect of extracorporeal shock wave lithotripsy for ureteral calculi treated by pneumatic lithotripsy under ureteroscope in short time

目的比较体外冲击波碎石术(ESWL)治疗输尿管结石失败后2周行输尿管镜气压弹道碎石术(URSL)与单纯行URSL临床价值。方法选取2018年6月至2020年6月本院收治的122例输尿管结石患者作为研究对象,按照治疗方案不同分为研究组(n=60)与对照组(n=62)。研究组于体外冲击波碎石失败2周后行URSL,对照组单纯行URSL。比较两组结石情况、术中情况、术后情况和疼痛、生命质量改善情况。结果两组结石位置、结石大小、结石CT平均值、麻醉方式占比及术中置管成功率、结石净石率、出血及发热发生率、住院时间比较差异均无统计学意义;研究组手术时间明显长于对照组,差异有统计学意义(P<0.05)。手术前后,两组疼痛分级评分(VRS)、健康调查简表(SF-36)比较差异均无统计学意义;术后,两组VRS评分均低于术前,SF-36评分均高于术前,差异有统计学意义(P<0.05)。结论对输尿管结石行ESWL术后2周予以URSL治疗,可有效处理输尿管结石,其净石率高,术后并发症较低,住院时间较短,提高患者术后生命质量,缓解疼痛,疗效确切,值得临床推广应用。

Objective To compare the clinical value of ureteroscopic pneumatic lithotripsis(URSL)2 weeks after the failure of extracorporeal shock wave lithotripsy(ESWL)for ureteral calculi with URSL alone.Methods A total of 122 patients with ureteral calculi admitted to our hospital from June 2018 to June 2020 were selected as the research subjects,and they were divided into study group(n=60)and control group(n=62)according to different treatment regimens.The study group underwent URSL 2 weeks after the failure of extracorporeal shock wave lithotripsy,and the control group underwent URSL.The stone situation,intraoperative situation,postoperative situation,pain and quality of life improvement were compared between the two groups.Results There were no significant differences in stone location,stone size,mean value of stone CT,proportion of anesthesia methods,success rate of intraoperative catheterization,stone free rate,incidence of bleeding and fever,and length of hospital stay between the two groups.The operation time in the study group was significantly longer than that in the control group,and the difference was statistically significant(P<0.05).Before and after operation,there was no significant difference in verbal rating scale(VRS)score and the MOS item short from health survey(SF-36)score between the two groups;after operation,the VRS scores of the two groups were lower than those before operation,and the SF-36 scores were higher than those before operation,and the differences were statistically significant(P<0.05).Conclusion URSL treatment for ureteral calculi 2 weeks after ESWL can effectively treat ureteral calculi,with high stone free rate,low postoperative complications,short hospital stay,improve the quality of life of patients after surgery,relieve pain,the curative effect is exact,and it is worthy of clinical promotion and application.