【摘要】 目的探讨药物保守治疗或输尿管镜碎石取石术两种方法治疗输尿管中下段小结石性肾绞痛的临床效果。方法 2012年7月至2013年4月间将40例输尿管中下段结石性肾绞痛患者随机分为两组。治疗组20例,应用输尿管镜碎石取石术,对照组20例采用排石、解痉药物保守治疗。结果与对照组相比,治疗组肾绞痛缓解率较高(P<0.05);肾绞痛再发生率较低(P<0.05);从入组到肾绞痛缓解所需时间平均较短(P<0.05)。治疗组清除结石的治愈率(95%,19/20)明显高于对照组(55%,11/20)(P<0.05),治疗组仅1例治疗失败,但拔出双J管1周后自行排出;对照组中9例保守治疗失败,其中3例通过体外冲击波碎石术治疗排出结石、6例采取输尿管镜碎石取石术最终取出结石。结论输尿管镜下碎石取石术治疗输尿管中下段小结石性肾绞痛可及早解除疼痛、减轻痛苦,且清除结石治愈率高,值得临床推广应用。更多还原

【Abstract】 Objective To compare the efficacy of emergency management of renal colic due to small middle or lower ureteral stone by ureteroscopic lithotripsy or conservative treatment. Methods From July 2012 to April 2013, 40 patients were randomly divided into 2 groups,each group owned 20 patients. The treatment group was treated by ureteroscopic lithotripsy, and the control group by drug treatment. Results Compared with the control group, the treatment group had higher remission rate for renal colic(P<0.05), lower recurrence rate of renal colic(P<0.05), and shorter time from renal colic occurrence to pain relief(P<0.05). The stone-free rate was higher in the treatment group(95%, 19/20) than that in the control group(55%, 11/20)(P<0.05). Ureteroscopic lithotripsy was successfully performed in 19 of 20 cases(95%) at first time, and only one case, who failed in the operation, at last discharged the stone by pulling out the double J tube in a week. However, drug treatment was failed in 9 cases of control group, and extracorporeal shock-wave lithotripsy was successfully performed in 3 cases, and ureteroscopic lithotripsy in 6 cases at last. Conclusion Ureteroscopic lithotripsy for emergency management of renal colic due to small middle or lower ureteral stone can relieve renal colic earlier and better, have higher stone-free rate, and is worthy of being widely applied in clinic.更多还原