输尿管镜钬激光碎石与体外冲击波碎石治疗急性肾绞痛的效果比较(1)
[摘要]目的 比较急诊输尿管镜钬激光碎石(URS)与急诊体外冲击波碎石(ESWL)两种方法治疗输尿管下段结石引起的急性肾绞痛的效果。方法 选取启东市第三人民医院2015年12月～2017年12月收治的110例输尿管下段结石合并急性肾绞痛患者作为研究对象，按照治疗方法的不同分为URS组(51例)与ESWL组(59例)。URS组采用URS的方法，ESWL组采用ESWL的方法。比较两组的视觉模拟量表(VAS)评分、清石率、效率商(EQ)和并发症。结果 两组治疗前后的VAS评分比较，差异有统计学意义(P<0.05)。当结石<10 mm时，URS组的手术时间、结石清除时间短于ESWL组，差异有统计学意义(P<0.05);当10 mm≤结石≤15 mm时，URS组的结石清除时间也短于ESWL组，差异有统计学意义(P<0.05)。两组的一次性清石率、辅治率比较，差异无统计学意义(P>0.05)。两组的EQ分别为70.4，48.6。结论 急诊URS和急诊ESWL均是输尿管下段结石并急性肾绞痛安全、有效的治疗方法，而对于直径≥10 mm的结石而言，URS疗效优于ESWL。
[关键词]输尿管下段结石;急性肾绞痛;输尿管镜;体外冲击波碎石
[中图分类号] R692.4 [文献标识码] A [文章编号] 1674-4721(2019)8(a)-0073-04
[Abstract] Objective To compare the clinical efficacy of ureteroscopic (URS) holmium laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones with acute renal colic. Methods From December 2015 to December 2017， a total of 110 patients with acute renal colic due to distal ureteral stones were enrolled in the Third People′s Hospital of Qidong City. The patients were divided into the URS group (51 cases) and the ESWL group (59 cases) according to different treatment methods. The URS group used URS holmium laser lithotripsy， and the ESWL group used ESWL. Visual analogue scale (VAS)， stone clearance rate， efficiency quotient (EQ) and complications were compared between the two groups. Results There was significant difference in the VAS scores in the two groups between before and after treatment (P<0.05). When the stone was less than 10 mm， the operation time and stone clearance time in the URS group were shorter than those in the ESWL group， and the difference was statistically significant (P<0.05). The stone clearance time in the URS group was shorter than that in the ESWL group when the stone size was less than 10 mm or less than 15 mm， the difference was statistically significant (P<0.05). There was no significant difference in disposable stone clearance rate and adjuvant treatment rate between the two groups (P>0.05). EQ of the two groups were 70.4 and 48.6 respectively. Conclusion Both URS and ESWL are safe and effective in the treatment of distal ureteral stones with renal colic. However when the stones were >10 mm， the clinical efficacy of URL is better than ESWL.
[Key words] Distal ureteral stone; Acute renal colic; Ureteroscope; Extracorporeal shock wave lithotripsy
急性腎绞痛是外科门诊最常见的急腹症之一，而且肾绞痛大多因输尿管结石而发生，且以输尿管下段结石为多见。急性肾绞痛一旦明确诊断，则需要积极干预，干预的主要目的是解除梗阻，防止脓毒症的发生。部分急性肾绞痛患者可通过保守治疗得以缓解，若肾绞痛依然不能缓解，则需要外科干预。输尿管镜钬激光碎石(URS)与体外冲击波碎石(ESWL)均是治疗输尿管下段结石的可选的外科方法。但是在急性肾绞痛时，急诊ESWL与急诊URS两种外科治疗方法相比较的文献并不多。本研究选取我院应用URS和ESWL治疗输尿管下段结石合并急性肾绞痛的110例患者，比较URS与ESWL后的清石率、效率商(EQ)和并发症。, 百拇医药(叶松云)
[关键词]输尿管下段结石;急性肾绞痛;输尿管镜;体外冲击波碎石
[中图分类号] R692.4 [文献标识码] A [文章编号] 1674-4721(2019)8(a)-0073-04
[Abstract] Objective To compare the clinical efficacy of ureteroscopic (URS) holmium laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) in the treatment of distal ureteral stones with acute renal colic. Methods From December 2015 to December 2017， a total of 110 patients with acute renal colic due to distal ureteral stones were enrolled in the Third People′s Hospital of Qidong City. The patients were divided into the URS group (51 cases) and the ESWL group (59 cases) according to different treatment methods. The URS group used URS holmium laser lithotripsy， and the ESWL group used ESWL. Visual analogue scale (VAS)， stone clearance rate， efficiency quotient (EQ) and complications were compared between the two groups. Results There was significant difference in the VAS scores in the two groups between before and after treatment (P<0.05). When the stone was less than 10 mm， the operation time and stone clearance time in the URS group were shorter than those in the ESWL group， and the difference was statistically significant (P<0.05). The stone clearance time in the URS group was shorter than that in the ESWL group when the stone size was less than 10 mm or less than 15 mm， the difference was statistically significant (P<0.05). There was no significant difference in disposable stone clearance rate and adjuvant treatment rate between the two groups (P>0.05). EQ of the two groups were 70.4 and 48.6 respectively. Conclusion Both URS and ESWL are safe and effective in the treatment of distal ureteral stones with renal colic. However when the stones were >10 mm， the clinical efficacy of URL is better than ESWL.
[Key words] Distal ureteral stone; Acute renal colic; Ureteroscope; Extracorporeal shock wave lithotripsy
急性腎绞痛是外科门诊最常见的急腹症之一，而且肾绞痛大多因输尿管结石而发生，且以输尿管下段结石为多见。急性肾绞痛一旦明确诊断，则需要积极干预，干预的主要目的是解除梗阻，防止脓毒症的发生。部分急性肾绞痛患者可通过保守治疗得以缓解，若肾绞痛依然不能缓解，则需要外科干预。输尿管镜钬激光碎石(URS)与体外冲击波碎石(ESWL)均是治疗输尿管下段结石的可选的外科方法。但是在急性肾绞痛时，急诊ESWL与急诊URS两种外科治疗方法相比较的文献并不多。本研究选取我院应用URS和ESWL治疗输尿管下段结石合并急性肾绞痛的110例患者，比较URS与ESWL后的清石率、效率商(EQ)和并发症。, 百拇医药(叶松云)