标准经皮肾镜联合膀胱软镜治疗肾结石对于血清同型半胱氨酸和β2-微球蛋白的表达影响  

The serum homocysteine and β2-microglobulin expression effects of standard percutaneous nephrolithotomy combined with bladder soft lens treatment of kidney stones

作　　者：刘光菊[1] 杜莹[1] 洪亚辰[1] 龚敏[1] 

机构地区：[1]湖北十堰市太和医院(湖北医药学院附属医院)泌尿外科,湖北十堰442000

出　　处：《临床和实验医学杂志》2017年第13期1312-1315,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨标准经皮肾镜联合膀胱软镜治疗肾结石对于血清同型半胱氨酸和β2-微球蛋白的表达影响。方法 2011年8月到2015年3月选择肾结石患者140例,根据随机抽签方法分为治疗组与对照组各70例,对照组采用肾实质切开取石术,治疗组采用标准经皮肾镜联合膀胱软镜治疗。对比观察两组围手术指标、并发症、肾功能、血清同型半胱氨酸和β2-微球蛋白水平。结果所有患者一次性清除结石,不过治疗组的手术时间、术中出血量、胃肠道功能恢复与术后住院时间都明显少于对照组(P<0.05)。治疗组术后14 d的肺部感染、肺不张、继发性出血、肠梗阻等并发症发生情况明显少于对照组(P<0.05)。两组术后14 d的血肌酐含量(92.44±10.33)μmol/L和(103.87±8.22)μmol/L,都明显高于术前的(67.44±9.87)μmol/L和(68.13±10.42)μmol/L(P<0.05),同时组间对比差异也有统计学意义(P<0.05)。两组术后14 d的血清同型半胱氨酸和β2-微球蛋白都呈现明显下降的趋势(P<0.05),同时术后14 d的血清同型半胱氨酸和β2-微球蛋白明显低于对照组(P<0.05)。结论标准经皮肾镜联合膀胱软镜治疗肾结石能降低血清同型半胱氨酸和β2-微球蛋白水平,有利于保护肾功能,减少术后并发症的发生。Objective To investigate the serum homocysteine and β2-microglobulin expression effects of standard percutaneous nephrolithotomy combined with bladder soft lens treatment of kidney stones.Methods From August 2011 to March 2015,140 kidney stones patients in our hospital for treatment were selected and equally divided into the treatment group and the control group based on a random draw,the control group were given the renal parenchyma lithotomy method,the treatment group were used standard percutaneous nephrolithotomy combined with bladder soft lens treatment.Results All patients were disposable clear stones,but the operative time,blood loss,recovery of gastrointestinal function and postoperative hospital stay in the treatment group were significantly less than those of the control group （P＆lt;0.05）.The postoperative 14d,lung infection,atelectasis,secondary hemorrhage,intestinal obstruction and other complications in the treatment group were significantly less than those of the control group （P＆lt;0.05）.The postoperative 14 d serum creatinine contents in the treatment group and the control group 92.44＆#177;10.33 μmol/L and 103.87＆#177;8.22 μmol/L that were significantly higher than those of preoperative of 67.44＆#177;9.87 μmol/L and 68.13＆#177;10.42 μmol/L （P＆lt;0.05）.The differences between the groups were statistically significant （P＆lt;0.05）.The postoperative14d serum homocysteine and β2-microglobulin were showed clear downward trend （P＆lt;0.05）,while the postoperative14d serum homocysteine and β2-microglobulin in the treatment group were lower than that of the control group （P＆lt;0.05）.Conclusion The standard percutaneous nephrolithotomy combined with bladder soft lens treatment of kidney stones can reduce the expression of serum homocysteine and β2-microglobulin,help protect kidney function,play minimally invasive effect,reduce postoperative complications occur,thus contributes to the rehabilitation of patients.

关 键 词：肾结石 膀胱软镜 经皮肾镜术 同型半胱氨酸 Β2-微球蛋白 

分 类 号：R699.2[医药卫生—泌尿科学]