急诊输尿管镜治疗输尿管结石并首次肾绞痛的疗效探讨被引量：1

Efficacy of Emergency Ureteroscopy in the Treatment of Ureteral Calculi with First Renal Colic

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摘要目的观察和分析急诊输尿管镜在输尿管结石并首次肾绞痛中的临床治疗效果。方法从2014年9月—2016年9月期间该院收治的所有输尿管结石合并肾绞痛患者中选取其中的120例患者作为该次的试验研究对象,将这120例患者按照不同的治疗方式分为观察组和对照组两组,两组各60例,其中观察组行急诊输尿管镜治疗,对照组行体外冲击波碎石术治疗;在观察组的60例患者中,根据患者首次肾绞痛时即行输尿管镜治疗和再次肾绞痛入院进行常规检查后再行输尿管镜治疗分为A组和B组,两组各30例;分别就观察组和对照组、A组和B组的治疗效果、并发症发生情况进行观察和对比。结果首先,从观察组和对照组两组不同治疗方法的治疗效果来看,两组患者的肾绞痛缓解率分别为93.33%和71.76%,首次碎石成功率为95.00%和78.33%,术后残石排净率为91.67%和66.67%;观察组患者的临床治疗效果显著优于对照组,差异有统计学意义(P<0.05);其次,从A组和B组两组患者不同时间段行输尿管镜的治疗效果来看,两组患者的清除率分别为96.67%和93.33%,两组患者的结石大小、清除率等方面差异无统计学意义(P>0.05)。结论对输尿管结石合并首次肾绞痛患者采用输尿管镜进行临床治疗,能够达到较高的清除率,及时解除患者的疼痛,具有临床推广的意义和价值。 Objective This paper tries to observe and analyze the clinical effect of emergency ureteroscopy in ureteral calculi and first renal colic. Methods 120 patients with ureteral calculi combined with renal colic from September 2014 to September 2016 were se-lected as the subjects in this study and were divided into the observation group and the control group according to different treatment methods, with 60 cases in each group. The observation group adopted emergency ureteroscopy treatment, the control group of extra-corporeal shock wave lithotripsy treatment; 60 patients in the observation group according to the patient first renal colic underwent ureteroscopy and were treated with ureteroscopy and were divided into group A and group B（ n=30）. The curative effect, complications of the the observation group, the control group, group A and group B were compared. Results First of all, from the different treatment methods of the observation group and control group, the effect of the two groups of patients with renal colic response rate were91.67% and 71.76% respectively, gravel success rate was 95.00% and 78.33% for the first time, postoperative residual stone free rate was 93.33% and 66.67%, the clinical curative effect of the observation group was better than the control group; and the difference was statistically significant（P〈0.05）. Secondly, the therapeutic effect of ureterorenoscopic realignment with different time line in group A and group B, the clearance rate of two groups of patients was 96.67% and 93.33% respectively, there were no significant differ-ences in calculous size and clearance between the two groups of patients, the difference was not statistically significant（ P〉0.05）. Conclusion The clinical treatment of ureteroscopy combined with the first renal colic for patients can achieve a higher clearance rate,timely lifting the patient’s pain, with clinical significance and value.