摘要
目的探讨接受输尿管镜下碎石术(URL)治疗的泌尿系结石患者术后支架管不同留置时间的临床价值。方法选择50例接受URL治疗的泌尿系结石患者为研究对象,根据术后支架管的留置时间分为对照组(23例)和观察组(27例)。对照组术后支架管留置4周,观察组术后支架管留置2周。比较两组患者拔管后的结石清除情况、置管期间止痛药应用情况、术后并发症发生率及手术前后的生活质量、肾功能。结果两组患者置管期间止痛药应用率及拔管后结石清除率比较,差异无统计学意义(P>0.05)。观察组下尿路感染、肉眼血尿、腰腹痛发生率分别为11.11%、7.41%、11.11%,均明显低于对照组的39.13%、30.43%、34.78%,差异有统计学意义(P<0.05)。两组患者支架管移位发生率比较,差异无统计学意义(P>0.05)。手术后,两组患者生理功能、生理职能、社会功能及情感职能评分均明显高于本组手术前,且观察组生理功能、生理职能、社会功能及情感职能评分分别为(85.41±12.27)、(68.49±10.51)、(78.36±11.91)、(75.61±13.05)分,均明显高于对照组的(74.62±11.07)、(52.32±9.27)、(63.69±10.54)、(62.18±11.23)分,差异有统计学意义(P<0.05)。手术前后,两组患者组间尿素氮(BUN)、肌酐(Cr)、尿酸(UA)水平比较,差异无统计学意义(P>0.05)。手术后,两组患者BUN、Cr、UA水平均较本组手术前降低,差异有统计学意义(P<0.05)。结论泌尿系结石患者URL术后支架管留置2周与留置4周均可取得较好的临床治疗效果,生活质量均得到明显改善,但支架管留置2周可大大降低置管相关并发症的发生率,临床应用价值更高。
Objective To discuss the clinical value of different stent retention time after surgery in urolithiasis patients undergoing ureteroscopic lithotomy(URL).Methods A total of 50 urolithiasis patients undergoing URL were divided into control group(23 cases)and observation group(27 cases)according to the postoperative stent retention time.The control group was retained for 4 weeks,and the observation group was retained for 2 weeks.Both groups were compared in terms of stone clearance after extubation,application of painkillers during catheterization,incidence of postoperative complications,quality of life and renal function preoperatively and postoperatively.Results There was no statistically significant difference in the application rate of painkillers during catheterization and stone clearance rate after extubation between the two groups(P>0.05).The incidence rates of lower urinary tract infection,gross hematuria and lumbago in the observation group were 11.11%,7.41%and 11.11%,which were significantly lower than those of 39.13%,30.43%and 34.78%in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of stent displacement between the two groups(P>0.05).Postoperatively,the scores of physical functioning,role-physical,social functioning and role-emotional in both groups were significantly higher than those preoperatively in this group;the scores of physical functioning,role-physical,social functioning and role-emotional in the observation group were(85.41±12.27),(68.49±10.51),(78.36±11.91)and(75.61±13.05)points,which were significantly higher than those of(74.62±11.07),(52.32±9.27),(63.69±10.54)and(62.18±11.23)points in the control group,and the differences were statistically significant(P<0.05).Preoperatively,there was no statistically significant difference in the levels of blood urea nitrogen(BUN),creatinine(Cr)and uric acid(UA)between the two groups(P>0.05).Postoperatively,BUN,Cr and UA levels in both groups were lower
作者
胡洺瑀
苟璇
HU Ming-yu;GOU Xuan(Urology Department,The First People's Hospital of Bijie City,Bijie 551700,China)
出处
《中国实用医药》
2023年第18期31-34,共4页
China Practical Medicine
