关键词:

钬激光碎石, 输尿管狭窄, 中药, 封堵器

Abstract:

Objective　To investigate the effect of traditional Chinese medicine prescription for clearing heat, promoting blood circulation, and softening combined with occluder in reducing ureteral stricture caused by holmium laser lithotripsy. Methods　Clinical data of 200 patients with middle and upper ureteral calculi from Guangdong Provincial Hospital of Integrated Traditional Chinese and Western Medicine from January 2015 to March 2023 were retrospectively analyzed, including 144 males and 56 females, aged (52±13.8) years. According to whether the occluder was used during operation and whether traditional Chinese medicine was used after operation, they were divided into group A (66 cases, holmium laser combined with occluder and traditional Chinese medicine), group B (70 cases, holmium laser alone), and group C (64 cases, holmium laser combined with occluder). Self-designed Chinese medicine prescription was as follow: spreading hedyotis herb, sophora, cordate houttuynia, glabrous greenbrier rhizome, epimedium, dogwood, grifola, alisma, motherwort, and radix cyathulae. The incidence of perirenal hematoma, ureteral stenosis, stone clearance rate, and improvement of hydronephrosis were observed 3 months after operation. F test, rank sum test, and χ² test were used. Results　There was no statistically significant difference in the incidence of perirenal hematoma among the three groups (χ²=2.474, P>0.05). There was a statistically significant difference in the incidence of postoperative ureteral stricture among the three groups (χ²=6.412, P<0.05); there was a statistically significant difference between group A and group B (χ²=5.402, P<0.05); there was no statistically significant difference between group A and group C (χ²=0.374, P>0.05); there was no statistically significant difference between group C and group B (χ²=3.331, P>0.05). There was a statistically significant difference in the stone clearance among the three groups (χ²=12.842, P<0.05); there was a statistically significant difference between group A and group B (χ²=9.597, P<0.05); there was no statistically significant difference between group A and group C (χ²=0.374, P>0.05); there was a statistically significant difference between group C and group B (χ²=7.022, P<0.05). There was no statistically significant difference in the improvement degree of hydronephrosis among the three groups (H=2.894, P>0.05). Conclusion　The treatment of middle and upper ureteral calculi with heat-clearing, blood-activating, and helping softening prescription combined with occluder can reduce the incidence of ureteral stricture or atresia caused by ureteral holmium laser lithotripsy, reflecting the effect of traditional Chinese medicine prescription on ureteral wall regeneration and repair, promoting blood circulation, clearing heat, reducing dampness, and promoting softening.

Key words:

Holmium laser lithotripsy, Ureteral stricture, Traditional Chinese medicine, Occluder