尿石通治疗输尿管结石及输尿管镜钬激光碎石术后残留结石的临床疗效

发布时间：2018-12-15 20:46

【摘要】：目的研究尿石通治疗输尿管结石及输尿管结石钬激光碎石术后残留结石的临床疗效。方法保守治疗:选取2013年1月至2015年12月门诊治疗的输尿管结石患者共4869例,随机分组。治疗组予以口服尿石通,对照组口服坦洛新,空白组不使用药物,治疗2周后比较各组间结石排出率及治疗有效率。术后辅助治疗:选取2013年1月至2015年12月行输尿管镜下钬激光碎石术的输尿管结石患者共662例,随机分组。治疗组术后予以口服尿石通,对照组口服坦洛新,空白组不使用药物,术后2周比较3组结石清除率。结果保守治疗:共入组患者3 193例,输尿管上段结石,治疗组结石排出率明显高于对照组及空白组(P0.05),其中6 mm以下结石治疗有效率无统计学差异(P0.05),6~10 mm的结石治疗有效率治疗组明显高于对照组及空白组(P0.05);输尿管下端结石:治疗组及对照组结石排出率明显高于空白组(P0.05),其中6 mm以下结石治疗有效率差异无统计学意义(P0.05),6~10 mm的结石治疗有效率治疗组及对照组明显高于空白组(P0.05)。术后辅助治疗:共入组患者482例,输尿管上段结石综合治疗后,治疗组结石清除率明显高于对照组及空白组(P0.05),输尿管中下段结石综合治疗后各组间结石清除率差异无统计学意义(P0.05)。结石10 mm治疗后,3组间结石清除率差异无统计学意义(P0.05),结石10 mm治疗后,治疗组结石清除率明显高于对照组及空白组(P0.05)。结论尿石通可治疗全程输尿管结石,提高结石排出率,输尿管镜下钬激光碎石术后辅以尿石通治疗可提高结石清除率,安全可靠,值得临床推广应用。
[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.
【作者单位】：上海交通大学医学院附属仁济医院泌尿外科;
【基金】：仁济医院横向课题(RJKY15-05)~~
【分类号】：R699

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