摘要
目的:探讨微通道与标准通道下经皮肾镜碎石术(PCNL)对老年肾结石患者排石效果及并发症的影响.方法:选取2017年7月-2019年7月收治的老年肾结石患者120例,依据随机数字表分为微通道组和标准通道组,每组60例,微通道组给予微通道下PCNL治疗,标准通道组给予标准通道下PCNL治疗,比较两组排石效果、围术期指标、肾功能[血尿素氮(BUN)、血肌酐(SCR)]、炎症应激反应[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]、并发症.结果:微通道组和标准通道组结石清除率比较差异无统计学意义(P>0.05);微通道组手术时间明显高于标准通道组,微通道组术中出血量、下床时间、住院时间明显低于标准通道组,差异有统计学意义(P<0.05);微通道组术后BUN、SCR、CRP、TNF-α、IL-6明显低于标准通道组,差异有统计学意义(P<0.05);微通道组并发症发生率明显低于标准通道组,差异有统计学意义(P<0.05).结论:与标准通道比较,微通道下PCNL治疗老年肾结石患者具有良好的排石效果,且可有效减少患者肾功能损伤及炎症应激反应,有利于减少术后并发症,值得临床推广.
Objective:To discuss the effect of percutaneous nephrolithotripsy(PCNL)under micro channel and standard channel on the stone removal and complications in elderly patients with renal calculi.Methods:A total of 120 elderly patients with renal calculi in our hospital from July 2017 to July 2019 were selected,and equally divided into micro channel group and standard channel group according to the random number table.The micro channel group was treated with PCNL via a micro channel,and the standard channel group was treated with PCNL via a standard channel.the stone removal effect,perioperative indexes,renal function[blood urea nitrogen(BUN)and serum creatinine(SCR)],inflammatory stress[C-reactive protein(CRP),tumor necrosis factor-alpha(TNF-alpha),interleukin-6(IL-6)],and complications were compared between the two groups.Results:There was no significant difference in stone clearance rate between the micro channel group and the standard channel group(P>0.05).The operation time in the micro channel group was significantly longer than that in the standard channel group,the bleeding volume,time out of bed and time of hospitalization in the micro channel group were significantly reduced as compared with those in the standard channel group with the difference being statistically significant(P<0.05).The BUN,SCR,CRP,TNF-alpha and IL-6 in the micro channel group were significantly lower than those in the standard channel group with the difference being statistically significant(P<0.05).The incidence of complications in micro channel group was significantly lower than that in standard channel group(P<0.05).Conclusions:Compare with the standard channel,PCNL via the micro channel has the good stone removal effect in elderly patients with renal calculi,and it can effectively reduce the renal function damage and inflammatory stress response of patients,which is helpful to reduce the postoperative complications,and worth for further clinical promotion.
作者
李建涛
唐晓旭
张立冬
谢家恩
赵军
王明川
陈舜琦
LI Jiantao;TANG Xiaoxu;ZHANG Lidong;XIE Jiaen;ZHAO Jun;WANG Mingchuan;CHEN Shunqi(Department of Urology,Chongqing Kaizhou District People's Hospital,Kaizhou District,Chongqing 405199,China)
出处
《微创泌尿外科杂志》
2020年第6期371-375,共5页
Journal of Minimally Invasive Urology
关键词
微通道
标准通道
经皮肾镜碎石术
老年
肾结石
排石
并发症
micro channel
standard channel
percutaneous nephrolithotripsy
elderly
renal calculi
stone removal
complications
作者简介
通信作者:唐晓旭,287435174@qq.com
