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目的:探讨化瘀补肾防石汤在肾盂输尿管连接部狭窄并发肾结石患者双镜术后的应用价值。方法:选择2013年3月—2016年12月该院择期接受双镜手术治疗的100例肾盂输尿管连接部狭窄并发肾结石患者作为研究对象,随机分为对照组与观察组各50例,两组均应用腹腔镜下肾盂成形术联合胆道镜碎石取石术治疗,对照组术后予常规处理,观察组加用化瘀补肾防石汤干预,比较两组碎石效果,观察手术前后患者症状、体征的变化,测定手术前后患者尿N-乙酰-β-氨基葡萄糖苷酶(NAG)、β微球蛋白(β-MG)、24 h枸橼酸盐、TH蛋白(THP)、骨桥蛋白(OPN)、间α-胰蛋白酶抑制物重链H3(ITIH3)的变化,统计术后并发症发生率。结果:(1)观察组治疗总有效率略高于对照组,但对比差异无统计学意义(P>0.05);(2)术后2周,两组各积分均降低,观察组各症状积分降低幅度低于对照组(P<0.05);(3)术后2周,观察组NAG、β-MG、THP、ITIH3降低,24 h枸橼酸盐上升,与对照组相比差异有统计学意义(P<0.05);(4)观察组术后感染、血尿、肾损伤发生率低于对照组(P<0.05)。结论:在肾盂输尿管连接部狭窄并发肾结石患者腹腔镜下肾盂成形术联合胆道镜碎石取石术后辅助应用化瘀补肾防石汤,疗效肯定,且可改善患者肾功能,减少术后并发症发生率。
Objective: To explore the application value of Shuyu Bushen Fangshi Decoction in patients with ureteropelvic junction stenosis after nephrolithiasis. Methods: From March 2013 to December 2016, 100 patients with ureteropelvic junctional stricture complicated with nephrolithiasis undergoing double-glaucoma surgery in our hospital were randomly divided into control group and observation group (50 cases each), and two groups Laparoscopic pyeloplasty and choledocholithotomy were used. The control group was treated with conventional treatment and the observation group was treated with the method of removing blood stasis and invigorating the kidney and preventing stones. The effect of lithotripsy and gravel was compared between the two groups. The symptoms, The changes of urine samples were measured before and after operation in patients with NAG, β-MG, 24 h citrate, TH protein, osteopontin OPN), the change of α-trypsin inhibitor heavy chain H3 (ITIH3), and the incidence of postoperative complications. Results: (1) The total effective rate of the observation group was slightly higher than that of the control group, but the difference was not statistically significant (P> 0.05); (2) After 2 weeks, the scores of the two groups were decreased, (P <0.05); (3) After 2 weeks, the levels of NAG, β-MG, THP and ITIH3 in the observation group decreased and the levels of citrate increased in the 24 h group (P <0.05). (4) The incidence of postoperative infection, hematuria and renal injury in the observation group was lower than that in the control group (P <0.05). CONCLUSIONS: Laparoscopic pyeloplasty combined with cholangiolithotomy in patients with renal pelvis and ureteropelvic junction stricture assisted the use of Huayu Bushen Fangshi Decoction with definite curative effect and can improve renal function and reduce postoperative complications Occurrence rate.