發(fā)布時(shí)間：2018-12-15 20:46

【摘要】：目的研究尿石通治療輸尿管結(jié)石及輸尿管結(jié)石鈥激光碎石術(shù)后殘留結(jié)石的臨床療效。方法保守治療:選取2013年1月至2015年12月門診治療的輸尿管結(jié)石患者共4869例,隨機(jī)分組。治療組予以口服尿石通,對(duì)照組口服坦洛新,空白組不使用藥物,治療2周后比較各組間結(jié)石排出率及治療有效率。術(shù)后輔助治療:選取2013年1月至2015年12月行輸尿管鏡下鈥激光碎石術(shù)的輸尿管結(jié)石患者共662例,隨機(jī)分組。治療組術(shù)后予以口服尿石通,對(duì)照組口服坦洛新,空白組不使用藥物,術(shù)后2周比較3組結(jié)石清除率。結(jié)果保守治療:共入組患者3 193例,輸尿管上段結(jié)石,治療組結(jié)石排出率明顯高于對(duì)照組及空白組(P0.05),其中6 mm以下結(jié)石治療有效率無統(tǒng)計(jì)學(xué)差異(P0.05),6~10 mm的結(jié)石治療有效率治療組明顯高于對(duì)照組及空白組(P0.05);輸尿管下端結(jié)石:治療組及對(duì)照組結(jié)石排出率明顯高于空白組(P0.05),其中6 mm以下結(jié)石治療有效率差異無統(tǒng)計(jì)學(xué)意義(P0.05),6~10 mm的結(jié)石治療有效率治療組及對(duì)照組明顯高于空白組(P0.05)。術(shù)后輔助治療:共入組患者482例,輸尿管上段結(jié)石綜合治療后,治療組結(jié)石清除率明顯高于對(duì)照組及空白組(P0.05),輸尿管中下段結(jié)石綜合治療后各組間結(jié)石清除率差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)石10 mm治療后,3組間結(jié)石清除率差異無統(tǒng)計(jì)學(xué)意義(P0.05),結(jié)石10 mm治療后,治療組結(jié)石清除率明顯高于對(duì)照組及空白組(P0.05)。結(jié)論尿石通可治療全程輸尿管結(jié)石,提高結(jié)石排出率,輸尿管鏡下鈥激光碎石術(shù)后輔以尿石通治療可提高結(jié)石清除率,安全可靠,值得臨床推廣應(yīng)用。
[Abstract]:Objective to study the clinical efficacy of Niaoshi Tong in the treatment of ureteral calculi and residual stones after holmium laser lithotripsy. Methods: 4869 patients with ureteral calculi from January 2013 to December 2015 were randomly divided into two groups. The treatment group was treated with Niaoshi Tong, the control group was treated with Tanluoxin, and the blank group was not treated with drugs. After 2 weeks of treatment, the stone excretion rate and the effective rate of the treatment were compared. Postoperative adjuvant treatment: 662 patients with ureteral calculi underwent ureteroscopic holmium laser lithotripsy from January 2013 to December 2015 were randomly divided into groups. The treatment group was treated with Niaoshi Tong, the control group was treated with tanloxine, the blank group was not treated with drugs, and the stone clearance rate of the three groups was compared 2 weeks after operation. Results conservative treatment: there were 3 193 cases of upper ureteral calculi in the treatment group. The stone excretion rate in the treatment group was significantly higher than that in the control group and the blank group (P0.05), and there was no significant difference in the effective rate of stone treatment under 6 mm (P0.05). The effective rate of stone treatment at 6 mm was significantly higher in the treatment group than in the control group and the blank group (P0.05). Lower ureteral calculi: the stone excretion rate in the treatment group and control group was significantly higher than that in the blank group (P0.05), and there was no significant difference in the effective rate of stone treatment under 6 mm (P0.05). The effective rate of stone treatment for 10 mm in the treatment group and control group was significantly higher than that in the blank group (P0.05). Postoperative adjuvant treatment: there were 482 patients in the treatment group. After comprehensive treatment of upper ureteral calculi, the stone clearance rate of the treatment group was significantly higher than that of the control group and the blank group (P0.05). There was no significant difference in stone clearance rate between groups after comprehensive treatment of middle and lower ureteral calculi (P0.05). After 10 mm of stone treatment, there was no significant difference in stone clearance rate among the three groups (P0.05). After 10 mm of stone treatment, the stone clearance rate of the treatment group was significantly higher than that of the control group and the blank group (P0.05). Conclusion Niaoshi Tong can treat ureteral calculi in the whole process and increase the stone excretion rate. After ureteroscopic holmium: YAG laser lithotripsy combined with ureteral lithotripsy can improve the stone clearance rate. It is safe and reliable and worthy of clinical popularization and application.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟(jì)醫(yī)院泌尿外科;
【基金】：仁濟(jì)醫(yī)院橫向課題(RJKY15-05)~~
【分類號(hào)】：R699

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