目的:探究健脾祛湿膏联合体外冲击波碎石治疗输尿管结石肥胖患者的效果.方法:选择2021年3-10月广州市中西医结合医院外科收治的 58 例输尿管结石肥胖患者为研究对象,随机分成对照组和观察组,各 29 例.其中,对照组采用体外冲击波碎石治疗,观察组采用健脾祛湿膏联合体外冲击波碎石治疗.比较两组并发症发生率、围手术期指标、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、尿α1-微球蛋白(α1-MG)水平及视觉模拟评分法(VAS)评分.结果:两组各项并发症发生率比较,差异无统计学意义(P>0.05).观察组住院天数、操作时间明显短于对照组,出血量明显少于对照组,差异有统计学意义(P<0.05).术前,两组NGAL、α1-MG水平比较,差异无统计学意义(P>0.05);术后 7 d,观察组NGAL、α1-MG水平明显低于对照组,差异有统计学意义(P<0.05).术前,两组VAS评分比较,差异无统计学意义(P>0.05);术后 7 d,观察组VAS评分明显低于对照组,差异有统计学意义(P<0.05).结论:健脾祛湿膏联合体外冲击波碎石治疗肥胖症输尿管结石患者效果显著,可减少出血量,缓解患者疼痛程度,提高治疗效果,改善患者生活质量.
Objective:To explore the effect of Jianpi Qushi Paste combined with extracorporeal shock wave lithotripsy in the treatment of obese patients with ureteral calculi.Method:A total of 58 obese patients with ureteral calculi admitted to the Surgery Department of Guangzhou Hospital of Integrated Traditional and Western Medicine from March to October 2021 were selected as the study objects,and they were randomly divided into control group and observation group,with 29 cases in each group.The control group was treated with extracorporeal shock wave lithotripsy,and the observation group was treated with Jianpi Qushi Paste combined with extracorporeal shock wave lithotripsy.The incidence of complications,perioperative indexes,levels of neutrophil gelatinase-associated lipocalin(NGAL),urinary α1-microglobulin(α1-MG)and visual analogue scale(VAS)were compared in both groups.Result:There were no significant differences in the incidence of complications between the two groups(P>0.05).The hospitalization days and operation time of the observation group were significantly shorter than those of the control group,and the blood loss was significantly less than that of the control group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in NGAL and α1-MG levels between the two groups(P>0.05).On the 7 d after operation,the levels of NGAL and α1-MG in the observation group were significantly lower than those in the control group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference in VAS scores between the two groups(P>0.05).On the 7 d after operation,the VAS score of the observation group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Jianpi Qushi Paste combined with extracorporeal shock wave lithotripsy has a significant effect in the treatment of obese patients with ureteral calculi,which can reduce blood loss,relieve patients'pain,improve treatment effect and improve patients'quality of life.