微创手术联合药物治疗输尿管结石疗效分析  

Clinical analysis of minimally invasive surgery combined with medication in the treatment of ureteral calculi

作　　者：陆巍[1] 王家强[1] 张玉洪[1] 王勇[1] 廉吉虎[1] 王潇然[1] 高庆圆 刘炳辰[1] 杜杉杉[1] 

机构地区：[1]吉林省人民医院泌尿外科,吉林长春130021

出　　处：《局解手术学杂志》2017年第9期664-668,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：吉林省卫生技术创新项目(2016J020)

摘　　要：目的探讨微创手术联合药物治疗输尿管结石的疗效。方法选取自2013年6月至2015年6月在我院住院治疗的124例X射线阳性输尿管结石患者作为研究对象,按照治疗方法的不同将患者分为对照组和观察组;对照组患者予以单纯用药保守治疗,观察组患者予以微创手术联合药物治疗。比较2组患者治疗效果,尿液中MCP-1、TFF1、HMGB1含量变化。结果观察组患者结石排出率、结石排净率明显高于对照组,差异有统计学意义(P<0.05);观察组患者结石排出时间和石街形成率明显低于对照组,差异有统计学意义(P<0.05);观察组患者共发生11例不良反应,对照组发生29例不良反应,观察组患者治疗后不良反应发生率明显低于对照组,差异有统计学意义(P<0.05);观察组治疗后17例发生药物副作用,对照组发生5例药物副作用,观察组患者药物副作用发生风险明显高于对照组,差异有统计学意义(P<0.05)。2组患者治疗后尿液中MCP-1、HMGB1含量较治疗前均有下降,TFF1含量明显升高,差异有统计学意义(P<0.05);观察组患者治疗后尿液中MCP-1、HMGB1含量明显低于对照组,TFF1含量明显高于对照组,差异具有统计学意义(P<0.05)。对照组患者治疗有效率为69.35%,观察组患者治疗有效率为88.71%,观察组患者的治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。结论输尿管结石患者在用药基础上,进行微创手术治疗,可促进结石的排出,缓解因结石引起的炎症反应,提高治疗效果。Objective To analyze of the efficacy of minimally invasive surgery combined with medication in the treatment of ureteral calculi. Methods From June 2013 to June 2015,124 patients with ureteral calculi which confirmed by X-ray in our hospital were collected as subjects. According to the treatment method, they were divided into control group and observation group, patients in the control group were treated with simple medication, while the observation group were treated with minimally invasive surgery combined with drug therapy. The effects of treatment and the levels of MCP-1 ,TFF1 and HMGB1 in urine between two groups were compared. Results The stone expulsion rate and the net rate of the observation group was higher than those of the control group, the differences were significant（ P 〈 0.05 ）. The stone expulsion time of observation group was shorter than that of the control group, the formation rate of the observation group was lower than that of the control group,the differences were significant （P 〈 0.05 ）. Adverse reactions occurred in 11 eases of the observation group,in 29 cases of the control group, the incidence of adverse reactions in the observation group was lower than that in the control group, the difference was significant （ P 〈 O. 05 ）. After the treatment, 17 cases of adverse drug reactions occurred in the observation group,which was more than 5 cases of adverse drug reactions in the control group,the difference was significant（ P 〈 0.05 ）. After treatment,the levels of MCP-1 and HMGB1 in urine of two groups were decreased compared with those before treatment, the level of TFF1 was increased, the differences were significant （P 〈 O. 05） ;while the levels of MCP-1 and HMGB1 of the observation group after treatment were lower than those of the control group, the level of TFF1 was higher than that of the control group ,the difference was significant（ P 〈0.05 ）. The effective rate of the observation group was 88.71% ,which higher than 69.35% of the control group,th

关 键 词：微创手术 甲基泼尼松 坦索罗辛 输尿管结石 

分 类 号：R693.4[医药卫生—泌尿科学]