化瘀补肾防石汤在肾盂输尿管连接部狭窄并发肾结石患者双镜术后中的应用研究  

Application of Huayu Bushen Fangshi Decoction in Patients with Ureteropelvic Junction Stricture Complicated with Renal Calculi after Combined Laparoscopic Cystoscopic Surgery

作　　者：何昆仑[1] 赵冬梅[2] 于千[1] 吕学新[1] 王长义[1] 李东[1] 

机构地区：[1]哈励逊国际和平医院(衡水市人民医院)泌尿外科,河北衡水053000 [2]哈励逊国际和平医院放疗科,河北衡水053000

出　　处：《辽宁中医杂志》2017年第9期1905-1908,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的:探讨化瘀补肾防石汤在肾盂输尿管连接部狭窄并发肾结石患者双镜术后的应用价值。方法:选择2013年3月—2016年12月该院择期接受双镜手术治疗的100例肾盂输尿管连接部狭窄并发肾结石患者作为研究对象,随机分为对照组与观察组各50例,两组均应用腹腔镜下肾盂成形术联合胆道镜碎石取石术治疗,对照组术后予常规处理,观察组加用化瘀补肾防石汤干预,比较两组碎石效果,观察手术前后患者症状、体征的变化,测定手术前后患者尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、β微球蛋白(β-MG)、24 h枸橼酸盐、TH蛋白(THP)、骨桥蛋白(OPN)、间α-胰蛋白酶抑制物重链H3(ITIH3)的变化,统计术后并发症发生率。结果:(1)观察组治疗总有效率略高于对照组,但对比差异无统计学意义(P>0.05);(2)术后2周,两组各积分均降低,观察组各症状积分降低幅度低于对照组(P<0.05);(3)术后2周,观察组NAG、β-MG、THP、ITIH3降低,24 h枸橼酸盐上升,与对照组相比差异有统计学意义(P<0.05);(4)观察组术后感染、血尿、肾损伤发生率低于对照组(P<0.05)。结论:在肾盂输尿管连接部狭窄并发肾结石患者腹腔镜下肾盂成形术联合胆道镜碎石取石术后辅助应用化瘀补肾防石汤,疗效肯定,且可改善患者肾功能,减少术后并发症发生率。Objective： To investigate the application value of Huayu Bushen Fangshi Decoction in patients with ureteropelvic junction stricture complicated with renal calculi after combined laparoscopic cystoscopic surgery. Methods： A total of 100 cases of patients with ureteropelvic junction stricture complicated with renal calculi treated by combined laparoscopic cystoscopic surgery in our hospital from March 2013 to December 2016 were selected and randomly divided into the control group and the observation group with 50 cases in each group. Both groups were treated with laparoscopic pyeloplasty combined with choledochoscopic lithotripsy. The control group received routine treatment after surgery and the observation group was treated with Huayu Bushen Fangshi Decoction. The effects of lithotripsy were compared between the two groups and the changes of symptoms and signs before and after the surgery were observed. Changes of urine N-acetyl-β-glucosaminidase（ NAG）,β microglobulin（ β-MG）,24 h citrate,TH protein（ THP）,osteopontin（ OPN） and inter-α-trypsin inhibitor heavy chain H3（ ITIH3） before and after surgery were determined and the incidence of complications after surgery was statistically analyzed. Results： The total effective rate of the observation group was slightly higher than that of the control group（ P〈0. 05）. 2 weeks after surgery,scores of the two groups were decreased,and the scores of symptoms in the observation group were lower than those in the control group（ P〈0. 05）. 2weeks after surgery,NAG,β-MG,THP and ITIH3 decreased,while 24 h citrate increased in the observation group. Compared with the control group,the differences were statistically significant（ P〈0. 05）. The incidence rates of infection,hematuria and renal injury in the observation group after surgery were lower than those in the control group（ P〈0. 05）. Conclusion： The application of Bushen Huayu Fangshi Decoction in patients with ureteropelvic junction stricture complicated with renal calcul

关 键 词：肾结石 肾盂输尿管连接部狭窄 化瘀补肾防石汤 

分 类 号：R692.4[医药卫生—泌尿科学]