肾绞痛发生后不同时间点行URL治疗输尿管中下段结石的疗效比较

目的 探讨肾绞痛发生后不同时间点行经输尿管镜碎石术（URL）治疗输尿管中下段结石临床疗效差异。方法 选择蚌埠市第三人民医院2012年1月至2015年9月行URL治疗输尿管中下段结石患者共98例，依据肾绞痛首次发作后14 d内和14 d后行手术治疗分为A组（50例）和B组（48例），比较两组患者手术时间、术前尿常规和尿培养检测感染发生率、一次性结石清除率、输尿管息肉检出率及术后第14天双J管拔除率等。结果 B组患者手术时间（48.60±7.84）min显著长于A组（38.23±5.35）min，差异有统计学意义（P<0.05）；B组患者术前尿常规检测感染发生率和输尿管息肉发生率显著高于A组（P<0.05）；B组患者术后第14天双J管拔除率显著低于A组（P<0.05）。结论 肾绞痛首次发作后14 d内行URL治疗输尿管中下段结石可有效缩短手术时间，减少术前尿路感染和输尿管息肉发生，并有助于缩短术后留置双J管时间。

Comparative study of URL therapy at different time points after renal colic in treatment of middle-lower ureteral calculi

Objective To investigate the differences of clinical efficacy of ureteroscopic lithotripsy (URL) at different time points after renal colic in the treatment of middle-lower ureteral calculi. Methods From Jan 2012 to Sep 2015, ninety-eight patients with middle-lower ureteral calculi underwent URL therapy in our hospital, and according to the URL implementing period after their first episode of ureteric colic, they were divided into group A (50 patients, within 14 days) and group B (48 patients, more than 14 days). The operation time, preoperative infection incidence examined by urine analysis and urine culture, first-time stone clearance rate, occurrence rate of ureter polyp, and removal rate of double-J tube at 2 weeks after operation were compared between the two groups. Results The operation time of group B was significantly longer than that of group A (48.60±7.84 min vs 38.23±5.35 min, P<0.05). The preoperative infection incidence tested by urine analysis and the occurrence rate of ureter polyp of group B were significantly higher than those of group A (P<0.05), but the removal rate of double-J tube of group B at 2 weeks after operation was significantly lower than that of group A (P<0.05). Conclusion Application of URL therapy in the treatment of middle-lower ureteral calculi within 14 days after first episode of renal colic could efficiently shorten operation time and indwelling time of double-J tube after operation, and reduce the occurrence of preoperative urine infection and ureter polyp.