摘要
目的:探析经皮肾镜辅助下气压弹道碎石取石术(PL)联合输尿管支架引流术在上尿路结石(UUTC)伴重度肾积水中的应用效果。方法:纳入本院泌尿外科2019年1月至2023年1月收治的84例UUTC伴重度肾积水患者,以随机数字表法分为对照组和观察组,每组42例。对照组给予钬激光碎石术联合输尿管支架引流术,观察组给予肾镜辅助下PL联合输尿管支架引流术。对比两组手术参数、术前术后肾脏相关因子[(尿内皮素-1(ET-1)、水通道蛋白-1(AQP-1)、血清内皮细胞特异性分子-1(ESM-1))]、一期取石成功率及并发症发生率。结果:两组住院时间对比无差异(P>0.05),观察组手术时间长于对照组,但碎石取石时间、术中出血量、术后血尿持续时间明显低于对照组,差异有统计学意义(P<0.05)。两组患者术前ET-1、AQP-1、ESM-1水平对比差异无统计学意义(P>0.05),而术后两组患者上述因子均明显降低,且观察组相比对照组ET-1[(15.44±2.26)vs.(18.31±2.58)ng/L]、AQP-1[(29.35±3.67)vs.(31.48±3.74)ng/L]、ESM-1[(0.77±0.14)vs.(1.15±0.16)ng/ml]水平均低,差异有统计学意义(P<0.05)。两组一期取石成功率(88.10%vs.90.48%)差异无统计学意义(P>0.05),观察组并发症总发生率(4.76%)明显低于对照组(21.43%),差异有统计学意义(P<0.05)。结论:肾镜辅助下PL联合输尿管支架引流术在UUTC伴重度肾积水患者中临床效果显著,值得推广。
Objective:Exploring the application of percutaneous nephrolithotripsy assisted pneumatic lithotripsy(PL)combined with ureteral stent drainage in upper urinary tract calculi(UUTC)with severe hydronephrosis.Method:84 patients with severe hydronephrosis and UUTC admitted to the department of urology in our hospital from January 2019 to January 2023 were randomly divided into control group(n=42)and observation group(n=42)using a random number table method.The control group received holmium laser lithotripsy combined with ureteral stent drainage,while the observation group received nephroscopy assisted PL combined with ureteral stent drainage.The surgical parameters,renal related factors(urinary endothelin 1(ET-1),aquaporin-1(AQP-1),serum endothe⁃lial cell specific molecule-1(ESM-1)),primary stone removal and complication rate were compared between the two groups.Result:There was no difference in the comparison of hospitalization time between the two groups(P>0.05).The observation group had a longer surgical time than the control group,but lithotripsy time,intraoperative blood,and postoperative hematuria duration were significantly lower than the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of ET-1,AQP-1,and ESM-1 between the two groups of patients before surgery(P>0.05).However,the above factors were significantly reduced in both groups after surgery,and there were statistically significant in the levels of ET-1[(15.44±2.26)vs.(18.31±2.58)ng/L],AQP-1[(29.35±3.67)vs.(31.48±3.74)ng/L]and ESM-1[(0.77±0.14)vs.(1.15±0.16)ng/ml]between the observation and control group(P<0.05).There was no statistically significant difference in the primary stone removal rate between the two groups(88.10%vs.90.48%)(P>0.05),while the total complication-srateof the observation groupwas significantly lower than that of the control group(4.76%vs.21.43%),with a statistically significant difference(P<0.05).Conclusion:Percutaneous nephrolithotripsy assisted PL combined with ureteral stent drainage has a significant clinical effect in UUTCpatients with severe hydronephrosis,and is worthy of promoting.
作者
成聪
许开良
曾金敏
周家杰
廖义翔
Cheng Cong;Xu Kailiang;Zeng Jinmin;Zhou Jiajie;Liao Yixiang(Department of Urology,Jingzhou Central Hospital,Jingzhou 434000)
出处
《微创泌尿外科杂志》
2023年第5期293-297,共5页
Journal of Minimally Invasive Urology
基金
湖北省卫生健康委员会资助项目(WJ2019Q020)
关键词
尿路结石
肾盂积水
肾镜取石术
经皮
输尿管
urinary tract calculus
hydronephrosis
nephrolithotomy,percutaneous
ureter
作者简介
通信作者:廖义翔,kunlug92678@163.com
