摘要
目的:比较输尿管镜下钬激光碎石术(URHL)与气压弹道碎石术(URSL)治疗中下段输尿管结石(UC)患者的效果。方法:回顾性分析2020年7月至2023年7月该院收治的106例中下段UC患者的临床资料,根据手术方法不同将其分为对照组和观察组各53例。对照组给予URSL治疗,观察组给予URHL治疗,比较两组一次性碎石率、围术期指标水平、手术前后氧化应激反应指标[白细胞介素-5(IL-5)、IL-8、C反应蛋白(CRP)]水平、肾功能指标[肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、胱抑素C(CysC)]水平及并发症发生率。结果:观察组一次性碎石率为96.23%(51/53),高于对照组的79.25%(42/53),差异有统计学意义(P<0.05);观察组手术时间、首次下床活动时间、住院时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);术后1、3 d,两组IL-5、CRP、IL-8水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);两组血清KIM-1、NGAL、CysC水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为1.89%(1/53),低于对照组的15.09%(8/53),差异有统计学意义(P<0.05)。结论:URHL治疗中下段输尿管结石患者可提高一次性碎石率,改善围术期指标水平,以及降低氧化应激反应指标水平、肾功能指标水平和并发症发生率的效果优于URSL治疗效果。
Objective:To compare effects of ureteroscopic Holmium laser lithotripsy(URHL)and pneumatic lithotripsy(URSL)in treatment of patients with middle and lower ureteral calculi(UC).Methods:The clinical data of 106 patients with middle and lower UC admitted to this hospital from July 2020 to July 2023 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,53 cases in each group.The control group was treated with URSL,while the observation group was treated with URHL.The one-time lithotripsy rate,the perioperative index levels,the oxidative stress response indexes[interleukin-5(IL-5),IL-8,C-reactive protein(CRP)]levels before and after the surgery,the renal function index[kidney injury molecule-1(KIM-1),neutrophil gelatinase-associated lipocalin(NGAL),cystatin C(CysC)]levels,and the incidence of complications were compared between the two groups.Results:The one-time lithotripsy rate of the observation group was 96.23%(51/53),which was higher than 79.25%(42/53)of the control group,and the difference was statistically significant(P<0.05).The operation time,the first out-of-bed time and the hospitalization time of the observation group were shorter than those of the control group,the intraoperative blood loss was less than that of the control group,and the differences were statistically significant(P<0.05).At 1 and 3 days after the surgery,the levels of IL-5,CRP and IL-8 in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The levels of serum KIM-1,NGAL and CysC in the two groups were higher than those before the surgery,but those in the observation group were lower than those the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 1.89%(1/53),which was lower than 15.09%(8/53)in the control group,and the difference was statistically significant(P<0.05).Conclusions:URHL in the treatment of the patients with middle and lower ureteral calculi can improve the one-time lithotripsy rate,improve the levels of perioperative indexes,and reduce the levels of oxidative stress response indexes,renal function indexes and the incidence of complications.Moreover,it is superior to single URSL treatment.
作者
彭展
PENG Zhan(Department of Urology of Shangqiu Central Hospital,Shangqiu 476000 Henan,China)
出处
《中国民康医学》
2024年第8期138-141,共4页
Medical Journal of Chinese People’s Health
关键词
输尿管镜
钬激光碎石术
气压弹道碎石术
输尿管结石
肾功能
氧化应激
并发症
Ureteroscopy
Holmium laser lithotripsy
Pneumatic lithotripsy
Ureteral calculus
Renal function
Oxidative stress
Complication
作者简介
彭展(1987.09-),男,汉族,河南夏邑人,本科,主治医师,研究方向为泌尿外科。
