微创经皮肾镜取石术对肾功能的影响  

Effects of mini- percutaneous nephrolithotripsy on renal function

作　　者：廖松柏[1] 于永刚[1] 武英杰[1] 刘为池[1] 梁毅文[1] 廖桂祥[1] 刘刚[1] 于管天[1] 

机构地区：[1]解放军第181医院泌尿外科,桂林541002

出　　处：《临床外科杂志》2011年第7期486-487,共2页Journal of Clinical Surgery

摘　　要：目的通过测定尿蛋白的改变明确微创经皮肾镜取石术对肾功能的影响。方法对50例复杂性肾结石患者行微创经皮肾镜取石术，术后即刻及术后每天留取患侧肾造瘘管尿标本定量测定尿微量白蛋白（尿Atb）及β2微球蛋白（尿β2-M）。结果术前尿微量白蛋白高于正常，术后即刻尿微量白蛋白明显增高，与术前相比差异有统计学意义（P〈0．05），此后尿微量白蛋白逐渐减少，但第5天尿微量自蛋白仍高于正常，与术前相比差异有统计学意义（P〈0．01）；术后即刻尿β2-M明显增高，与术前相比差异有统计学意义（P〈0．01），此后逐渐恢复，于术后第4日恢复至术前水平，术前相比无显著性差异（P〉0．05），术后第5天较术前相比差异有统计学意义（P〈0．05），尿β2-M趋于更少。结论微创经皮肾镜取石术后出现了短暂肾功能损害，在保持通畅引流及避免感染的情况下肾功能逐渐好转，但仍需一定时间才能恢复。Objective To explore the effect of mini - percutaneous nephrolithotripsy（MPCNL） on renal function by measuring urinary protein. Method Fifty patients with complicated renal calculi were treated by MPCNL,and the urinary protein excretion through ipsilateral nephrostomy catheter was measured instantly and every day after operation. The urinary proteins included urinary microalbumin （ u - Alb ） and urinary β2 - mieroglobulin（ u - β2 - M ）. Results The u - Alb was abnormal before operation, and was increased obviously shortly after operation, and then decreased gradually, but it was still abnormal in the fifth day after operation. The u - Alb levels were significantly higher after MPCNL than those before opera- tion（P 〈0.01 ）. The amount of u - β2 - M was increased up obviously shortly after operation ,and then de- creased gradually. There was significant difference in u - β2 - M levels before and 1,2,3 days after opera- tion（P 〈0.01 ）. The u - β2 - M levels recovered to those at the fourth day after MPCNL（ P 〉 0.05 ）. At the fifth day, u - [$2 - M levels were decreased further as compared with those before operation （ P 〈 0.05 ）. Conclusion There may be temporary deterioration of the renal function after MPCNL. If only they have no obstruction and free from infection, the renal function should become as usual, but they still need much time to recover.

关 键 词：复杂性肾结石 微创经皮肾镜取石术 肾功能 

分 类 号：R692.4[医药卫生—泌尿科学]