B超引导下体外冲击波碎石治疗输尿管上段结石的研究
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摘要
目的针对B超引导下体外冲击波碎石术治疗输尿管上段结石的效果进行研究和探讨。方法选取我院2012年1月~2017年6月期间收治的患者共计417例,按照入院先后顺序分为体外组(n=217)和输尿管镜组(n=200),输尿管镜组患者实施输尿管镜下气压弹道碎石术,体外组患者在B超引导下实施体外冲击波碎石术治疗,对比分析两组患者各项临床指标、治疗效果及并发症发生率。结果体外组患者在疼痛消失时间、肉眼血尿持续时间、下床活动时间、住院时间等各项临床指标中均优于输尿管镜组,差异有统计学意义(P<0.05);输尿管镜组患者治疗总有效率高于体外组,体外组并发症发生率低于输尿管镜组,差异有统计学意义(P<0.05)。结论尿管镜下气压弹道碎石术虽然并发症相对较高,但碎石成功率较高,在治疗输尿管上段结石无效时,可使用B超引导下体外冲击波碎石术代替,该手术方式相对容易掌握,并发症少,费用低,两者可互补。
Objective To study and discuss the effect of extracorporeal shock wave lithotripsy(ESWL) guided by B-ultrasound in the treatment of ureteral calculi. Methods A total of 417 cases from January 2012 to June 2017 in our hospital were selected and divided into extracorporeal group(n=217) and ureteroscopy group(n=200) according to the order of admission.In ureteroscopy group,ureteroscopic pneumatic lithotripsy was performed and extracorporeal shock wave lithotripsy was performed under the guidance of B-mode ultrasound.The clinical indexes,therapeutic effect and complication rate of the two groups were compared and analyzed. Results The time of pain disappearance,the duration of hematuria,the time of getting out of bed and the time of hospitalization of the patients in the external group were superior to the ureteroscopy group(P < 0.05).The total effective rate of ureteroscopy group was higher than that of external group,and the incidence of complications in external group was lower than that in ureteroscopy group(P < 0.05). Conclusion Although the complications of pneumatic lithotripsy under ureteroscopy are relatively high,the success rate of lithotripsy is relatively high.When the treatment of upper ureteral calculi is ineffective,ESWL guided by B-ultrasound can be used instead,which is relatively easy to master.The complication is less, the cost is low,the two can complement each other.
Objective To study and discuss the effect of extracorporeal shock wave lithotripsy(ESWL) guided by B-ultrasound in the treatment of ureteral calculi. Methods A total of 417 cases from January 2012 to June 2017 in our hospital were selected and divided into extracorporeal group(n=217) and ureteroscopy group(n=200) according to the order of admission.In ureteroscopy group,ureteroscopic pneumatic lithotripsy was performed and extracorporeal shock wave lithotripsy was performed under the guidance of B-mode ultrasound.The clinical indexes,therapeutic effect and complication rate of the two groups were compared and analyzed. Results The time of pain disappearance,the duration of hematuria,the time of getting out of bed and the time of hospitalization of the patients in the external group were superior to the ureteroscopy group(P < 0.05).The total effective rate of ureteroscopy group was higher than that of external group,and the incidence of complications in external group was lower than that in ureteroscopy group(P < 0.05). Conclusion Although the complications of pneumatic lithotripsy under ureteroscopy are relatively high,the success rate of lithotripsy is relatively high.When the treatment of upper ureteral calculi is ineffective,ESWL guided by B-ultrasound can be used instead,which is relatively easy to master.The complication is less, the cost is low,the two can complement each other.
引文
[1]魏青峰,杨慧.B超引导下体外冲击波碎石术治疗泌尿系结石的临床效果[J].世界临床医学,2017,11(19):174.
[2]雷庆华,高社全,霍韶军,等.体外冲击波碎石与逆行输尿管镜钬激光碎石处理输尿管上段结石的临床研究[J].河北医药,2013,35(1):57-59.
[3]胡岩,秘书方,郭付臣,等.体外冲击波碎石术治疗小儿泌尿系结石[J].疑难病杂志,2012,11(9):718-719.
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[5]张劲航,谭付清.体外冲击波碎石术与输尿管镜下钬激光碎石术治疗输尿管上段结石的临床疗效比较[J].浙江医学,2015,37(15):1309-1311.
[6]韩景智,李永禄,孟辉,等.消石汤配合体外冲击波碎石术治疗泌尿系结石50例[J].现代中西医结合杂志,2012,21(12):1295-1296.
[7]高勇.三金解毒通淋汤配合体外冲击波碎石术治疗泌尿系结石疗效观察[J].现代中西医结合杂志,2017,26(19):2149-2151.
[8]杨二江,杨勇.中药排石复方颗粒配合体外冲击波碎石术治疗泌尿系结石疗效观察[J].湖北中医杂志,2016,38(8):17-18.
[9]周立权,黎承杨,杨占斌,等.两种微创手术治疗复杂性输尿管上段结石比较研究[J].微创泌尿外科杂志,2015,4(2):92-94.
[10]田小梅.对行体外冲击波碎石术的泌尿系结石患者实施综合护理的效果探析[J].当代医药论丛,2016,14(22):185-186.
[11]金铎,李大鹏.输尿管支架管在体外冲击波碎石术治疗泌尿系结石中的应用价值[J].中国实用乡村医生杂志,2016,23(8):65-66,67.
[12]陈嗣平,林友岳,蔡邦联,等.药物结合体外冲击波碎石术在输尿管上段结石治疗中的应用分析[J].浙江创伤外科,2016,21(1):18-20.
[13]王爱芹.体外冲击波碎石术治疗泌尿系结石的护理体会[J].中国当代医药,2013,20(36):124-125.
[14]曹刚,郑如华,金永有,等.B超监测在输尿管镜气压弹道碎石术治疗输尿管上段结石的应用研究[J].中国内镜杂志,2014,20(6):659-661.
[15]尤洪科,董功航,尹永华.B超引导下经皮肾镜碎石清石术治疗肾、输尿管上段结石的临床观察与并发症处理[J].岭南现代临床外科,2016,16(5):605-607.
[16]郭子臣,包建成,王惠泉,等.体外冲击波碎石术治疗泌尿系结石的注意事项[J].世界临床医学,2016,10(10):123.
[2]雷庆华,高社全,霍韶军,等.体外冲击波碎石与逆行输尿管镜钬激光碎石处理输尿管上段结石的临床研究[J].河北医药,2013,35(1):57-59.
[3]胡岩,秘书方,郭付臣,等.体外冲击波碎石术治疗小儿泌尿系结石[J].疑难病杂志,2012,11(9):718-719.
[4]汤虎.B超定位体外冲击波碎石术治疗泌尿系结石患者的临床疗效分析[J].饮食保健,2016,3(24):28.
[5]张劲航,谭付清.体外冲击波碎石术与输尿管镜下钬激光碎石术治疗输尿管上段结石的临床疗效比较[J].浙江医学,2015,37(15):1309-1311.
[6]韩景智,李永禄,孟辉,等.消石汤配合体外冲击波碎石术治疗泌尿系结石50例[J].现代中西医结合杂志,2012,21(12):1295-1296.
[7]高勇.三金解毒通淋汤配合体外冲击波碎石术治疗泌尿系结石疗效观察[J].现代中西医结合杂志,2017,26(19):2149-2151.
[8]杨二江,杨勇.中药排石复方颗粒配合体外冲击波碎石术治疗泌尿系结石疗效观察[J].湖北中医杂志,2016,38(8):17-18.
[9]周立权,黎承杨,杨占斌,等.两种微创手术治疗复杂性输尿管上段结石比较研究[J].微创泌尿外科杂志,2015,4(2):92-94.
[10]田小梅.对行体外冲击波碎石术的泌尿系结石患者实施综合护理的效果探析[J].当代医药论丛,2016,14(22):185-186.
[11]金铎,李大鹏.输尿管支架管在体外冲击波碎石术治疗泌尿系结石中的应用价值[J].中国实用乡村医生杂志,2016,23(8):65-66,67.
[12]陈嗣平,林友岳,蔡邦联,等.药物结合体外冲击波碎石术在输尿管上段结石治疗中的应用分析[J].浙江创伤外科,2016,21(1):18-20.
[13]王爱芹.体外冲击波碎石术治疗泌尿系结石的护理体会[J].中国当代医药,2013,20(36):124-125.
[14]曹刚,郑如华,金永有,等.B超监测在输尿管镜气压弹道碎石术治疗输尿管上段结石的应用研究[J].中国内镜杂志,2014,20(6):659-661.
[15]尤洪科,董功航,尹永华.B超引导下经皮肾镜碎石清石术治疗肾、输尿管上段结石的临床观察与并发症处理[J].岭南现代临床外科,2016,16(5):605-607.
[16]郭子臣,包建成,王惠泉,等.体外冲击波碎石术治疗泌尿系结石的注意事项[J].世界临床医学,2016,10(10):123.