泄热逐瘀排石汤辅助经尿道输尿管镜下碎石术治疗输尿管上段结石的效果

Effect of Xiere Zhuyu Paishi Decoction Auxiliary the Transurethral Ureteroscopic Lithotripsy in the Treatment of Upper Ureteral Calculi

目的:观察泄热逐瘀排石汤辅助经尿道输尿管镜下碎石术治疗输尿管上段结石的效果。方法:选取2021年1月—2023年9月大田县总医院收治的103例输尿管上段结石患者。根据随机数表法将其分为研究组(n=52)和对照组(n=51)。对照组给予经尿道输尿管镜下碎石术治疗,研究组在对照组基础上给予泄热逐瘀排石汤治疗。比较两组临床疗效、并发症、相关指标、肾功能、尿动力学。结果:研究组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。研究组住院时间短于对照组;两组术后14 d视觉模拟评分法(visual analog score,VAS)评分降低,研究组VAS评分低于对照组,差异有统计学意义(P<0.05)。术后14 d,两组血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)水平均降低,研究组组Scr、BUN均低于对照组,差异有统计学意义(P<0.05)。术后14 d,两组最大尿流率和最大尿道压(maximum urethral pressure,MUP)均升高,研究组最大尿流率和MUP均高于对照组,差异有统计学意义(P<0.05)。结论:泄热逐瘀排石汤辅助经尿道输尿管镜下碎石术治疗输尿管上段结石效果较好,能够显著缓解患者临床症状,协助清除残余结石,提高肾功能和尿动力学,减轻术后疼痛应激,治疗安全性和实用性较高。

Objective:To observe the effect of Xiere Zhuyu Paishi Decoction auxiliary the transurethral ureteroscopic lithotripsy in the treatment of upper ureteral calculi.Method:A total of 103 patients with upper ureteral calculi admitted to Datian General Hospital from January 2021 to September 2023 were selected.They were divided into study group(n=52)and control group(n=51)according to random number table method.The control group was treated with transurethral ureteroscopic lithotripsy,and the study group was treated with Xiere Zhuyu Paishi Decoction based on the control group.The clinical efficacy,complications,related indexes,renal function and urodynamics were compared between the two groups.Result:The total effective rate of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The time of hospitalization was shorter than that in the control group,the visual analog score(VAS)of the two groups reduced at 14 d after surgery,and the VAS score of the study group was lower than that of the control group,the differences were statistically significant(P<0.05).At 14 d after treatment,serum creatinine(Scr)and blood urea nitrogen(BUN)levels were decreased in both groups,Scr and BUN in study group were lower than those in control group,the differences were statistically significant(P<0.05).After 14 d of treatment,the maximum urethral flow rate and maximum urethral pressure(MUP)of the two groups were increased,and the maximum urethral flow rate and MUP of the study group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion:The treatment of upper ureteral calculi with the Xiere Zhuyu Paishi Decoction auxiliary the transurethral ureteroscopic lithotripsy has a good effect,which can significantly alleviate the clinical symptoms of patients,help remove residual calculi,improve renal function and urodynamics,and alleviate postoperative pain and stress,and the treatment is safe and practical.