摘要
目的 探讨输尿管软镜钬激光碎石术(FURL)治疗对直径1~2 cm输尿管上段结石患者结石清除率和血清C-反应蛋白(CRP)、胱抑素C(Cys-C)水平的影响。方法 回顾性分析84例输尿管上段结石患者,根据不同治疗方式分为观察组和对照组,每组42例。对照组行经皮肾镜取石术(PCNL),观察组行FURL。比较两组患者手术相关指标、结石清除率、应激反应情况、炎症因子水平、肾功能及并发症发生率。结果 观察组患者的手术时间长于对照组,住院时间短于对照组,术中出血量、血红蛋白下降值低于对照组(t分别=-2.69、6.89、10.62、4.33,P均<0.05);两组结石清除率比较,差异无统计学意义(χ~2=1.05,P>0.05);术后1 d,观察组患者的血管紧张素-Ⅱ(Ang-Ⅱ)、肾上腺素(AD)、皮质醇、尿素氮(BUN)、Cys-C、血肌酐(Scr)水平均低于对照组(t分别=12.05、7.19、7.63、2.66、3.43、2.16,P均<0.05);术后3 d,观察组患者的外周血白细胞计数(WBC)、CRP、白介素-10(IL-10)均低于对照组(t分别=9.90、15.11、12.62,P均<0.05)。观察组并发症发生率低于对照组(χ~2=5.23,P<0.05)。结论 对直径1~2 cm输尿管上段结石患者行FURL,可有效清除结石,减轻机体炎症及应激反应,降低并发症发生。
Objective To explor the effects of ureteral soft mirror holmium laser lithotripsy(FURL)treatment on stone clearance rate and serum C-reactive protein(CRP)and cystatin C(Cys-C)levels in patients with upper ureteral calculi with a diameter of 1-2 cm.Methods A retrospective analysis was conducted on 84 patients with upper ureteral calculi.They were divided into an observation group and a control group based on different treatment methods,with 42 cases in each group.The control group underwent percutaneous nephrolithotomy(PCNL),while the observation group un-derwent FURL.The surgical related indicators,stone clearance rate,stress response,levels of inflammatory factors,renal function,and incidence of complications between two groups were compared.Results The operation time of observation group was longer than that of control group,the hospitalization time was shorter than that of control group,and the intra-operative blood loss and hemoglobin decline value were lower than that of control group(t=-2.69,6.89,10.62,4.33,P<0.05).There was no significant difference in stone clearance rate between the two groups(χ2=1.05,P>0.05).On the first day after surgery,the levels of angiotensin-Ⅱ(Ang-Ⅱ),adrenaline(AD),cortisol,urea nitrogen(BUN),Cys-C,and serum creatinine(Scr)in the observation group were lower than those in the control group(t=12.05,7.19,7.63,2.66,3.43,2.16,P<0.05).Three days after surgery,the peripheral blood white blood cell count(WBC),CRP,and interleukin-10(IL-10)in the observation group were lower than those in the control group(t=9.90,15.11,12.62,P<0.05).The inci-dence of complications in the observation group was lower than that in the control group(χ2=5.23,P<0.05).Conclusion Performing FURL on patients with upper ureteral calculi with a diameter of 1-2 cm can effectively clear the stones,alleviate inflammation and stress reactions,reduce the incidence of complications,and have high clinical promotion value.
作者
徐乃奋
郑定钦
张志刚
林阳阳
周青英
XU Naifen;ZHENG Dingqin;ZHANG Zhigang(Department of Urinary Surgery,Pingyang Hospital Affiliated to Wenzhou Medical University,Wenzhou 325400,China)
出处
《全科医学临床与教育》
2023年第11期995-998,共4页
Clinical Education of General Practice
关键词
输尿管软镜
钬激光碎石术
结石
输尿管
flexible ureteroscope
holmium laser lithotripsy
stone
ureter
作者简介
通讯作者:周青英,Email:20412077@qq.com。
