经皮肾镜联合输尿管软镜治疗老年肾结石的疗效及其对患者肾功能、尿激酶、甲状腺素水平的影响  

Effect of percutaneous nephrolithotomy combined with flexible ureter in the treatment of elderly patients with kidney stone and influence for kidney function,urokinase and thyroid hormone levels

作　　者：李锋[1] 王飞[1] 

机构地区：[1]嘉应学院医学院附属医院外科,广东梅州514031

出　　处：《海南医学》2017年第4期572-574,共3页Hainan Medical Journal

基　　金：广东省梅州市科技计划项目(编号:2014B126)

摘　　要：目的观察经皮肾镜联合输尿管软镜治疗老年肾结石的临床疗效,并探讨其对患者肾功能、尿激酶、甲状腺素水平的影响。方法选取2012年7月至2015年10月我院外科收治的66例老年肾结石患者为研究对象,按照随机数字表法分为对照组(经皮肾镜治疗)和观察组(经皮肾镜联合输尿管软镜治疗),每组33例,比较两组患者不同肾结石的结石清除率、手术时间、住院时间、术前及术后1 d、2 d、3 d及7 d的肾功能指标、尿激酶、甲状腺素水平。结果观察组患者的复杂及非复杂肾结石的清除率分别为100.00%及96.97%,均高于对照组的76.92%及85.00%,观察组复杂及非复杂肾结石患者的手术时间及住院时间分别为(69.42±7.10)min、(58.42±6.03)min及(4.24±0.57)d、(3.08±0.37)d,均短于对照组的(86.76±8.20)min、(75.34±7.263)min及(6.15±0.72)d、(5.20±0.61)d,术后1 d、2 d、3 d及7 d的肾功能指标及甲状腺素水平均低于对照组,而血清尿激酶水平则高于对照组,差异均有统计学意义(P<0.05)。结论经皮肾镜联合输尿管软镜治疗老年肾结石的临床疗效较好,且对患者的肾功能、尿激酶及甲状腺素水平的不良影响较少,具有临床推广应用价值。Objective To observe and study the clinical effect ofpercutaneous nephrolithotomy combined with flexible ureter in the treatment of elderly patients with kidney stone and the influence on kidney function, urokinase and thyroid hormone levels. Methods Sixty-six elderly patients with kidney stone in our hospital from July 2012 to Octo- ber 2015 were selected as the study objects, and they were divided into control group （percutaneous nephrolithotomy, 33 cases） and observation group （percutaneous nephrolithotomy combined with flexible ureter, 33 cases） by stratified randomization. Then the stone clearance rates of different kidney stones, operation time and hospitalization time, kidney function indexes, urokinase and thyroid hormone levels before the operation and at the first, second, third and seventh day after the operation of two groups were compared. Results The stone clearance rate of complicated calculi and non-complicated calculi in the observation group were respectively 100.00% and 96.97%, which were significantly high- er than 76.92% and 85.00% in the control group. The operation time and hospitalization time of the observation group were （69.42±7.10） rain, （4.24±0.57） d for complicated calculi and （58.42±6.03） min, （3.08±0.37） d for non-complicated calculi, which were all significantly shorter than （86.76±8.20） min, （6.15±0.72） d and （75.34±7.263） min, （5.20±0.61） d of the control group. The kidney function and thyroid hormone levels at the first, second, third and seventh day after the operation were all significantly lower than those of the control group, while the serum urokinase level was significantly higher than that of control group. The differences were all significant （P〈0.05）. Conclusion Compared with percutane- ous nephrolithotom alone, percutaneous nephrolithotomy combined with flexible ureter has better clinical effect in the treatment of elderly patients with kidney stone, and the adverse influence is weaker on kidney function, urokinase

关 键 词：经皮肾镜 输尿管软镜 老年 肾结石 肾功能 尿激酶 甲状腺素 

分 类 号：R692.4[医药卫生—泌尿科学]