内镜联合口服碳酸氢钠碎石治疗胃石症的疗效观察  

Curative effectiveness of endoscopy combined with drug lithotripsy for patients with gastrolithiasis

作　　者：李晓宁[1] 姜瑾[1] 吕宜光[1] LI Xiao-ning;JIANG Jin;LV Yi-guang(The Third People＇s Hospital of Dalian City, Dalian 116031 , China)

机构地区：[1]大连市第三人民医院,大连116031

出　　处：《内科急危重症杂志》2018年第1期25-27,共3页Journal of Critical Care In Internal Medicine

基　　金：2011年大连市卫生局课题资助项目(No:2011-25)

摘　　要：目的:探讨内镜联合口服碳酸氢钠(NaHCO3)碎石治疗胃石症的时机并分析疗效。方法:选择84例胃石症患者,均采用内镜碎石术治疗,随机分为4组,各21例,A组未联合用药,B、C、D 3组术前均口服5%NaHCO3溶液125 m L,4次/d,分别用药3、5、7 d后取石,比较4组患者疗效。结果:(1)4组随服药时间的延长,首次取石成功率均上升,D组首次取石成功率为95.24%,高于其他3组(均P<0.05);(2)A、B、C、D 4组手术时间依次缩短,以D组手术时间最短,为(36.19±16.54)min(均P<0.05);(3)随用药时间的延长A、B、C、D 4组各维度胃肠疾病生命指数(GIQLI)评分增高,以D组各维度评分最高(均P<0.05);4组中D组胃石体积最小,住院费用最低(均P<0.05);(4)4组不良反应发生率差异无统计学意义(P>0.05)。结论:内镜结合口服5%NaHCO3溶液治疗胃石症首次取石成功率高,以服药7 d后取石疗效更为显著,更节省住院费用。Objective： To compare the timing and curative effect of endoscopy combined with oral sodium bicarbonate（NaHCO3） lithotripsy for patients with gastrolithiasis. Methods： Eighty-four cases of gastrolithiasis were treated by endoscopic lithotripsy and randomly divided into four groups,21 cases in each. Group A was not treated with combined medication,and groups B,C and D were treated with oral 5% sodium bicarbonate solution before operation,125 m L,4 times/day. The stones were removed at 3rd,5th and 7th day after administration respectively. The effectiveness of lithotripsy in the four groups was compared. Results：（1） The success rate of initial lithotripsy in groups A,B,C and D increased with the extension of the medication time,and the success rate of initial lithotripsy in group D（95. 24%） was higher than that in groups A,B and C（P〈0.05）;（2） The operation time in groups A,B,C and D was shortened gradually. The operation time in group D was the shortest [（36. 19 ± 16. 54） min],（P〈0.05）;（3） With the extension of the medication time,GIQLI scores of different dimensions in groups A,B,C and D increased and those in group D were the highest（P〈0.05）. Among groups A,B,C and D groups,the gastrolith volume in group D was smallest and hospitalization expenses were the lowest.（4） There was no significant difference among the four groups in the incidence of complications（P〈0.05）. Conclusions：Endoscopy combined with oral administration of 5% sodium bicarbonate solution in the treatment of gastrolithiasis can obtain the high success rate of lithotripsy. The curative effects of lithotripsy after 7 days of medication before operation is more significant,with better economy.

关 键 词：胃石症 碳酸氢钠 碎石 经济性 

分 类 号：R573.8[医药卫生—消化系统]