【摘要】：目的：評(píng)價(jià)清熱化瘀法對(duì)輸尿管結(jié)石經(jīng)輸尿管鏡碎石術(shù)后排石作用的臨床療效及安全性。方法：將我院2013年10月至2015年10月單純輸尿管結(jié)石,結(jié)石大小為8～20mm,行輸尿管鏡碎石術(shù)病例368例,隨機(jī)分為兩組,清熱化瘀法治療組186例,對(duì)照組182例。所有患者術(shù)后1、2、4周復(fù)查泌尿系統(tǒng)B超或X線腹部平片(KUB),并行尿常規(guī)等檢查。主要觀察兩組患者的結(jié)石碎塊排凈時(shí)間、尿潛血、腰腹部疼痛程度及發(fā)生率等療效指標(biāo)變化。所有數(shù)據(jù)均以SPSS19.0統(tǒng)計(jì)軟件進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果：清熱化瘀法治療組患者在術(shù)后1、2周的結(jié)石排凈率分別為67.74%、90.32%,明顯優(yōu)于對(duì)照組的45.60%、74.18%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)；而治療組患者在術(shù)后4周結(jié)石排凈率98.92%,與對(duì)照組的98.35%比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。治療組患者在術(shù)后1、2、4周尿潛血情況較對(duì)照組患者尿潛血情況要輕,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療組腰腹部疼痛發(fā)生率為53.76%,與對(duì)照組的68.13%比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),并且治療組腰腹部疼痛嚴(yán)重程度比對(duì)照組明顯要輕,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論：輸尿管結(jié)石經(jīng)輸尿管鏡碎石術(shù)后應(yīng)用清熱化瘀法治療能明顯促進(jìn)結(jié)石排出,縮短患者的排石時(shí)間,并且減少血尿及腰腹部疼痛發(fā)生,促進(jìn)患者及早康復(fù)。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of removing heat and removing blood stasis in the treatment of ureteral calculi after ureteroscopic lithotripsy. Methods: from October 2013 to October 2015, 368 cases of ureteroscopic lithotripsy were randomly divided into two groups: 186 cases in the treatment group and 182 cases in the control group. All the patients were examined with B-ultrasound or X-ray plain film (KUB), and urine routine at 1: 2 and 4 weeks postoperatively. The time of stone removal, urine occult blood, the degree and incidence of pain in waist and abdomen were observed. All the data were analyzed by SPSS19.0 statistical software. Results: the stone removal rate in the treatment group was 67.74 and 90.32 respectively at 1 and 2 weeks after operation, which was significantly better than that in the control group (45.60,74.18) (P0.05). In the treatment group, the stone removal rate was 98.92% 4 weeks after operation, and there was no significant difference between the treatment group and the control group (98.35%) (P0.05). In the treatment group, the occult blood condition of the patients in the treatment group was lighter than that in the control group at 1 and 2 weeks postoperatively (P0.05). The incidence of lumbar abdominal pain in the treatment group was 53.76, which was significantly different from that in the control group (68.13%) (P0.05), and the severity of lumbar abdominal pain in the treatment group was significantly lighter than that in the control group. The difference was statistically significant (P0.05). Conclusion: the treatment of ureteral calculi through ureteroscopic lithotripsy can obviously promote the excretion of stones, shorten the time of lithotomy, reduce the occurrence of hematuria and pain in the waist and abdomen, and promote the early recovery of the patients.
【學(xué)位授予單位】：山東中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R699.4

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