后腹腔镜肾窦内肾盂切开取石术与经皮肾镜碎石取石术的术后创伤程度比较  

Comparison of the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy

作　　者：俞家顺 王健[2] 刘定益[2] 唐崎[2] 周燕峰[2] 李文敏[2] 

机构地区：[1]同济大学医学院,上海200092 [2]上海市浦东新区浦南医院泌尿外科,上海200125

出　　处：《海南医学院学报》2017年第15期2102-2104,2108,共4页Journal of Hainan Medical University

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养基金(PWRq2015-23);上海市浦东新区卫生系统重点学科建设资助(PWZx2014-19)

摘　　要：目的:研究后腹腔镜肾窦内肾盂切开取石术(RLIP)与经皮肾镜碎石取石术(PCNL)的术后创伤程度。方法:选择2013年9月~2017年2月在上海市浦东新区浦南医院诊断为肾盂单发结石的118例患者,随机分为RLIP组和PCNL组,分别接受后腹腔镜肾窦内肾盂切开取石术和经皮肾镜碎石取石术。术后1周和4周时观察结石排出情况,术后3d和7d时采集肘静脉血3mL,并检测肾功能指标、炎症指标及应激指标。结果:RLIP组患者术后1周和术后4周时的取石成功率均显著高于PCNL组,RLIP组和PCNL组患者术后3d及7d时血清中BUN、Scr、Cys-C含量以及eGFR水平无显著性差异,RLIP组患者术后3d及7d时血清中Cor、NE、HSP70、NO、IL-6、hs-CRP、TNF-α、PGE2的含量均显著低于PCNL组。结论:RLIP的取石效果显著优于PCNL且术后创伤程度显著弱于PCNL。Objective： To study the postoperative trauma of the retroperitoneal laparoscopic intrasinusal pyelolithotomy （RLIP） and percutaneous nephrolithotomy （PCNL）. Methods.. A total of 118 patients who were diagnosed with single pelvis calculus in Shanghai Punan Hospital of Pudong New District between September 2013 and February 2017 were selected and randomly divided into RLIP group and PCNL group who received retroperitoneal laparoscopic intrasinusal pyelolithotomy and percutaneous nephrolithotomy respectively. The removal of the stones was observed 1 week and 4 weeks after surgery, and 3 mL of cubital venous blood was collected 3 days and 7 days after operation to detect the renal function indicators, inflammatory markers and stress indicators. Results： The stone removal success rates of RLIP group 1 week and 4 weeks after operation were significantly higher than those of PCNL group （P〈0.05）, serum BUN, Scr and Cys-C contents as well as eGFR levels were not significantly different between RLIP group and PCNL group 3 days and 7 days after operation （P〉0.05）, and serum （;or, NE, HSP70, NO, IL-6, hs CRP, TNF-α and PGE2 contents of RI.IP group 3 days and 7 days after operation were significant- ly lower than those of PCNL group（P〈0.05）. Conclusions： RI.IP is significantly better than PCNL in stone removal and it causes significantly less postoperative trauma than PCNL. [KEY WORDS] Renal calculi; Retroperitoneal laparoscopic intrasinusal pyelolithotomy; Percutaneous nephrolithotomy; Inflammatory response; Stress response

关 键 词：肾结石 后腹腔镜肾窦内肾盂切开取石术 经皮肾镜碎石取石术 炎症反应 应激反应 

分 类 号：R692.4[医药卫生—泌尿科学]