内镜联合口服碳酸氢钠碎石治疗胃石症的疗效观察

摘要

Objective:To compare the timing and curative effect of endoscopy combined with oral sodium bicarbonate (NaHCO3) lithotripsy for patients with gastrolithiasis.Methods:Eighty-four cases of gastrolithiasis were treated by endoscopic lithotripsy and randomly divided into four groups,21 cases in each.Group A was not treated with combined medication,and groups B,C and D were treated with oral 5％ sodium bicarbonate solution before operation,125 mL,4 times/day.The stones were removed at 3rd,5th and 7th day after administration respectively.The effectiveness of lithotripsy in the four groups was compared.Results:① The success rate of initial lithotripsy in groups A,B,C and D increased with the extension of the medication time,and the success rate of initial lithotripsy in group D (95.24％) was higher than that in groups A,B and C (P ＜ 0.05);② The operation time in groups A,B,C and D was shortened gradually.The operation time in group D was the shortest [(36.19 ± 16.54) min],(P ＜ 0.05);③ With the extension of the medication time,GIQLI scores of different dimensions in groups A,B,C and D increased and those in group D were the highest (P ＜ 0.05).Among groups A,B,C and D groups,the gastrolith volume in group D was smallest and hospitalization expenses were the lowest.④ There was no significant difference among the four groups in the incidence of complications (P ＞ 0.05).Conclusions:Endoscopy combined with oral administration of 5％ sodium bicarbonate solution in the treatment of gastrolithiasis can obtain the high success rate of lithotripsy.The curative effects of lithotripsy after 7 days of medication before operation is more significant,with better economy.%目的:探讨内镜联合口服碳酸氢钠(NaHCO3)碎石治疗胃石症的时机并分析疗效.方法:选择84例胃石症患者,均采用内镜碎石术治疗,随机分为4组,各21例,A组未联合用药,B、C、D3组术前均口服5％ NaHCO3溶液125 mL,4次/d,分别用药3、5、7d后取石,比较4组患者疗效.结果:①4组随服药时间的延长,首次取石成功率均上升,D组首次取石成功率为95.24％,高于其他3组(均P＜0.05);②A、B、C、D4组手术时间依次缩短,以D组手术时间最短,为(36.19±16.54) min(均P＜0.05);③随用药时间的延长A、B、C、D4组各维度胃肠疾病生命指数(GIQ-LI)评分增高,以D组各维度评分最高(均P＜0.05);4组中D组胃石体积最小,住院费用最低(均P＜0.05);④4组不良反应发生率差异无统计学意义(P＞0.05).结论:内镜结合口服5％ NaHCO3溶液治疗胃石症首次取石成功率高,以服药7d后取石疗效更为显著,更节省住院费用.