B超引导下体外冲击波碎石联合盐酸坦索罗辛对输尿管结石患者的治疗效果  

Therapeutic effects of B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication on ureteral calculi

作　　者：金诚 陈鹏鹏 Cheng Jin;Pengpeng Chen(Graduate School,Zhejiang Chinese Medical University,Hangzhou 310053,Zhejiang Province,China;Department of Urology,Ninghai First Hospital,Ningbo 315600,Zhejiang Province,China)

机构地区：[1]浙江中医药大学研究生院,杭州310053 [2]宁海县第一医院泌尿外科,宁波315600

出　　处：《中国基层医药》2023年第1期102-107,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探究B超引导下体外冲击波碎石联合盐酸坦索罗辛对输尿管结石患者的治疗效果。方法:回顾性分析宁海县第一医院2019年3月至2020年6月收治的输尿管结石患者130例的临床资料,根据患者所接受的治疗方式的不同分为观察组和对照组,每组65例。对照组患者实施B超引导下体外冲击波碎石术,观察组患者在对照组的基础上给予盐酸坦索罗辛。比较两组患者治疗总有效率、首次治疗后结石排净率、结石排出时间、治疗次数、首次治疗14 d后视觉模拟评分法(VAS)评分。观察两组患者肾功能指标[血肌酐(Scr)、血尿素氮(BUN)],平均动脉压(MAP)、VAS评分、出血量及免疫球蛋白水平[IgG、IgM、丙二醛(MDA)、超氧化物歧化酶(SOD)]情况。结果:对照组患者治疗总有效率[89.23%(58/65)]低于观察组[98.46%(64/65)](χ^(2)=4.80,P<0.05)。治疗14 d后,观察组患者治疗后VAS评分[(3.97±0.36)分]显著低于对照组[(5.59±0.87)分](t=13.87,P<0.05)。治疗后,对照组的输尿管结石首次治疗排净率[61.54%(40/65)]显著低于观察组[78.46%(51/65)](χ^(2)=4.43,P<0.05);结石排净时间[(18.98±3.52)d]、治疗次数[(2.53±0.50)次]均显著高于观察组[(12.27±2.77)d、(1.64±0.55)次](t=12.08、9.66,均P<0.05);观察组尿Kim-1[(89.46±42.46)mmol/L]高于对照组[(72.75±17.65)mmol/L],Scr[(101.75±24.53)μmol/L]和BUA[(348.76±29.84)μmol/L]均显著低于对照组[(139.53±30.56)μmol/L、[(397.65±35.64)μmol/L](t=-2.93、5.82、8.48,均P<0.05);观察组麻醉诱导后20 min MAP[(83.45±12.65)mmHg](1 mmHg=0.133 kPa)显著高于对照组[(61.68±9.75)mmHg],术中出血量[(112.65±30.74)mL]显著低于对照组(170.68±35.67)mL](t=-10.99、9.94,均P<0.05);观察组IgG[(8.56±1.74)g/L]和MDA[(7.74±0.74)mol/L]均显著高于对照组[(7.75±1.68)g/L、(5.21±0.65)mol/L](t=2.70、20.71,均P<0.05),IgM[(1.23±0.32)g/L]和SOD[(71.75±8.57)U/mL]均显著低于对照组[(1.55±0.45)g/L、(90.64±9.73)U/mL](t=-4.67、-11.75,均P<Objective To investigate the therapeutic effects of B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication on ureteral calculi.Methods The clinical data of 130 patients with ureteral calculi who received treatment in Ninghai First Hospital from March 2019 to June 2020 were retrospectively analyzed.These patients were divided into an observation group and a control group(n=65/group)according to the different treatment methods.Patients in the control group received B ultrasound-guided extracorporeal shock wave lithotripsy,and those in the observation group received B ultrasound-guided extracorporeal shock wave lithotripsy combined with tamsulosin hydrochloride medication.Total response rate,stone-free rate after the first treatment,time taken to get rid of stone,treatment times,and Visual Analogue Scale(VAS)score 14 days after the first treatment were compared between the two groups.Renal function indexes(serum creatinine,blood urea nitrogen),mean arterial pressure,VAS score,blood loss,and immunoglobulin G,immunoglobulin M,malondialdehyde,superoxide dismutase levels were determined in the two groups.Results The total response rate in the control group was significantly lower than that in the observation group[89.23%(58/65)vs.98.46%(64/65),χ^(2)=4.80,P<0.05].After 14 days of treatment,the VAS score in the observation group was significantly lower than that in the control group(3.97±0.36)points vs.(5.59±0.87)points,t=13.87,P<0.05.After treatment,the stone-free rate after the first treatment in the control group was significantly lower than that in the observation group[61.54%(40/65)vs.78.46%(51/65),χ^(2)=4.43,P<0.05].The time taken to get rid of stone and treatment times in the control group were(18.98±3.52)days and(2.53±0.50)times,respectively,which were significantly higher than(12.27±2.77)days and(1.64±0.55)times in the observation group(t=12.08,9.66,both P<0.05).Urine Kim-1 in the observation group was significantly higher than that in the control group

关 键 词：输尿管结石 超声引导 碎石术 肾上腺素能Α拮抗剂 疼痛 免疫球蛋白 出血 肾功能 治疗结果 

分 类 号：R699.4[医药卫生—泌尿科学]