摘要
目的:探讨肾结石患者分别采用经皮肾镜钬激光碎石取石术与输尿管软镜钬激光碎石术治疗的效果及对其肾功能和炎性指标的临床影响。方法:本文选取汉川市中医医院收治的150例肾结石患者进行回顾性分析,病例选取时间为2021年1月—2022年12月,所有观察对象均采用钬激光碎石术治疗,根据术中采用的不同器械将观察对象分为两组,在钬激光碎石术中采用经皮肾镜的患者纳入对照组(n=75),在钬激光碎石术中采用输尿管软镜的患者纳入观察组(n=75),对比两组的临床总有效率、治疗前后的肾功能指标、炎性指标及并发症发生率。结果:观察组中有58例显效、16例有效,总有效率为98.67%,对照组有52例显效、15例有效,总有效率为89.33%,两组相比,差异有统计学意义(P<0.05);两组术后3d的尿素(UREA)、胱抑素(Cys-C)、血清肌酐(Scr)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)均高于治疗前,但观察组均低于对照组,差异均有统计学意义(P<0.05);两组术后3 d的白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素-10(IL-10)均高于治疗前,但观察组均低于对照组,差异均有统计学意义(P<0.05);统计两组术后并发症发生情况发现,观察组术后仅出现1例感染,发生率为1.33%,对照组则有2例感染、1例肾穿孔、1例急性肾功能不全,发生率为5.33%,两组相比,差异无统计学意义(P>0.05)。结论:肾结石患者在钬激光碎石术中采用输尿管软镜的效果较显著,不仅可以有效改善其肾功能,还可以减轻其炎症反应,且安全性良好。
Objective:To investigate the clinical effects of percutaneous nephroscopic holmium laser lithotripsy and ureteroflexible holmium laser lithotripsy on renal function and inflammatory indexes in patients with renal calculus.Method:In this paper,150 patients with renal calculi admitted to Hanchuan Hospital of Traditional Chinese Medicine were retrospectively analyzed.The case selection period was from January 2021 to December 2022,and all observation subjects were treated with holmium laser lithotripsy.According to the different instruments used during the surgery,the observation subjects were evenly divided into two groups.Patients who underwent percutaneous nephroscopy during holmium laser lithotripsy were included in the control group(n=75),patients who underwent ureteroscopy during holmium laser lithotripsy were included in the observation group(n=75),and the clinical total effective rate,renal function indicators and inflammatory indexes before and after treatment,and incidence of complications were compared between the two groups.Result:58 cases were significantly effective and 16 cases were effective in the observation group,with a total effective rate of 98.67%,in the control group,52 cases were significantly effective and 15 cases were effective,with a total effective rate of 89.33%,the difference between the two groups was statistically significant(P<0.05).3 days after surgery,urea(UREA),cystatin(Cys-C),serum creatinine(Scr)and neutrophil gelatinase-associated lipid carrier protein(NGAL)in two groups were higher than those before treatment,but those in observation group were lower than those in control group,the differences were statistically significant(P<0.05).The white blood cell count(WBC),C reactive protein(CRP)and interleukin-10(IL-10)in both groups were higher than those before treatment,but those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Statistics on the incidence of postoperative complications in two groups showed that only one case of infection occurred in the observation group,with an incidence rate of 1.33%,in the control group,there were two cases of infection,one case of renal perforation,and one case of acute renal insufficiency,with an incidence rate of 5.33%,the difference between the two groups was not statistically significant(P>0.05).Conclusion:The use of ureteroscopy in holmium laser lithotripsy for patients with renal calculi has a significant effect.It can not only effectively improve their renal function,but also reduce their inflammatory response,and has good safety.
作者
何未
郑利军
李荣
HE Wei;ZHENG Lijun;LI Rong(Urology Department,Hanchuan Hospital of Traditional Chinese Medicine,Hanchuan 431600,China)
出处
《中国医学创新》
CAS
2024年第15期38-42,共5页
Medical Innovation of China
关键词
肾结石
经皮肾镜钬激光碎石取石术
输尿管软镜钬激光碎石术
肾功能
炎性指标
Renal calculi
Percutaneous nephrolithotripsy with holmium laser lithotripsy
Ureteroscopic holmium laser lithotripsy
Renal function
Inflammatory indexes
作者简介
通信作者:何未。
