芪金合剂对输尿管镜下钬激光碎石术病人术后残石率及结石复发的影响  

Effect of Qijin mixture on residual stone rate and stone recurrence in patients undergoing ureteroscopic holmium laser lithotripsy

作　　者：叶林朋[1] 彭鄂军 吕源 YE Linpeng;PENG Ejun;LV Yuan(Department of Urology Surgery,Huangmei County People's Hospital,Hubei Province,Huangmei 314686,China)

机构地区：[1]湖北省黄梅县人民医院泌尿外科,435500

出　　处：《临床外科杂志》2023年第7期677-680,共4页Journal of Clinical Surgery

摘　　要：目的探讨芪金合剂对输尿管镜下钬激光碎石术病人术后残石率及结石复发的影响。方法2015年10月~2020年10月于我院就诊的输尿管上段结石病人108例,根据术后是否服用芪金合剂分成对照组和研究组,每组各54例,两组病人均进行输尿管镜下钬激光碎石术,对照组术后采取传统自然排石治疗,研究组在对照组基础上给予芪金合剂治疗。所有病人于治疗结束后3天、1个月和6个月后复查,对比两组术后残石率、结石复发情况及术后并发症。结果两组病人血尿、腹痛、尿频尿急、排尿灼热感及中医症候总积分较治疗前均显著降低,差异有统计学意义(P<0.05),研究组各症状较对照组轻,中医症候总积分均低于对照组,差异有统计学意义(P<0.05);研究组临床治疗效果的总有效率为96.30%,高于对照组的85.19%,研究组结石清除率高于对照组;腰痛、发热、感染、尿路刺激等并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组术后3天残石率比较差异无统计学意义(P>0.05)。术后1个月经腹部平片检查,研究组病人无残余结石,对照组仍有8例病人有残余结石,差异有统计学意义(P<0.05);术后6个月泌尿系统CT复查,研究组未见结石复发;对照组有残石的8例病人中5例病人结石直径增大,可见结石复发,无残石的46例病人中2例发现新的结石,研究组结石复发率低于对照组,差异有统计学意义(P<0.05)。结论芪金合剂用于输尿管镜下钬激光碎石术后排石效果显著,可加速术后残石排出,降低术后结石复发率,减少并发症发生。Objective To investigate the effect of Qijin mixture on residual stone rate and stone recurrence after ureteroscopic holmium laser lithotripsy.Methods A total of 108 patients with upper ureteral calculi treated in our hospital from October 2015 to October 2020 were randomly divided into control group(n=54)and study group(n=54).Patients in both groups were treated with Ureteroscopic holmium laser lithotripsy,the control group was treated with traditional natural stone removal,and the study group was treated with Qijin mixture on the basis of the control group.All patients were reexamined 3 days,1 month and 6 months after the end of treatment.The postoperative residual stone rate and postoperative complications were compared between the two groups.Results After treatment,hematuria,abdominal pain,frequency and urgency of urination,burning sensation of urination,and the total score of TCM symptoms in the two groups were significantly lower than those before treatment(P<0.05).The symptoms of the study group were slighter than those of the control group,and the total score of TCM symptoms was lower than that of the control group(P<0.05).The total effective rate of the study group was 96.30%,which was higher than 85.19% of the control group(P<0.05).The stone clearance rate of the study group was higher than that of the control group(P<0.05).The total incidence of complications such as low back pain,fever,infection and urinary tract irritation was lower than that of the control group(P<0.05).There was no significant difference in the residual stone rate between the two groups at 3 days after operation(P>0.05).Abdominal X-ray examination 1 month after operation showed no residual stones in the study group,while 8 patients in the control group still had residual stones(P<0.05).CT examination of urinary system 6 months after operation showed no recurrence of calculi in the study group.In the control group,5 of the 8 patients with residual stones had increased stone diameter and stone recurrence was visible,and 2 of the 46 p

关 键 词：芪金合剂 输尿镜下激光碎石术 残石率 结石复发 

分 类 号：R699.4[医药卫生—泌尿科学]