输尿管镜下钬激光碎石术对输尿管结石患者应激反应及肾功能的影响  

Effect of Ureteroscopic Holmium Laser Lithotripsy on the Stress Reaction and Renal Function of Patients with Ureteral Calculus

作　　者：郭一泓[1] 李毅宁[1] 张建育[1] 王加良[1] 穆鑫[1] 

机构地区：[1]福建医科大学附属第二医院泌尿外科,福建泉州362000

出　　处：《中外医疗》2017年第24期21-23,共3页China & Foreign Medical Treatment

摘　　要：目的探讨输尿管镜下钬激光碎石术对输尿管结石患者应激反应及肾功能的影响。方法方便选择2014年1月—2016年12月期间在该院治疗的750例输尿管结石患者作为研究对象,根据随机数表法将其分为观察组与对照组,各375例。对照组采用气压弹道碎石术,观察组采用钬激光碎石术,比较两组碎石情况、应激反应及肾功能指标变化。结果观察组碎石成功率为98.67%、结石排净率为96.80%,均高于对照组的90.40%、84.80%,而输尿管损伤发生率(1.60%)低于对照组(5.60%),差异有统计学意义(P<0.05);术后观察组Cor(241.12±29.03)ng/m L、MDA(6.43±1.55)nmol/L水平低于对照组[(263.87±34.42)ng/m L、(9.85±1.72)nmol/L],SOD(71.24±16.64)NU/m L水平高于对照组(62.89±14.96)NU/m L,差异有统计学意义(P<0.05);术后1个月观察组Scr(108.52±31.65)μmo L、BUN(4.35±1.06)mmol/L水平低于对照组[(133.34±38.79)μmo L、(6.72±1.19)mmol/L],差异有统计学意义(P<0.05)。结论与气压弹道碎石术治疗输尿管结石相比,钬激光碎石术碎石成功率、结石清除率更高,且对输尿管造成的损伤小,引起的应激反应轻,有利于改善患者的肾功能指标,可作为临床治疗输尿管结石的首选术式。Objective To study the effect of ureteroscopic holmium laser lithotripsy on the stress reaction and renal function of patients with ureteral calculus. Methods 750 cases of patients with ureteral calculus treated in our hospital from January 2014 to December 2016 were convenient selected as the research objects and randomly divided into two groups with 375 cases in each, the control group and the observation group were respectively treated with ballistic lithotripsy and holmium laser lithotripsy, and the detritus situation, stress reactions and renal function index changes were compared between the two groups. Results The detritus success rate and stone free rate in the observation group were higher than those in the control group,(98.67%, 96.80% vs 90.40% 、84.80%), and the incidence rate of ureteral injury in the observation group was lower than that in the control group,(1.60% vs 5.60%), and the difference was statistically significant(P<0.05), and the Cor and MDA levels in the observation group after surgery were lower than those in the control group[(241.12±29.03)ng/m L(6.43±1.55)nmol/L vs(263.87±34.42)ng/m L、(9.85±1.72)nmol/L], and the SOD level was higher than that in the control group[(71.24±16.64)NU/m L vs(62.89±14.96)NU/m L], and the difference was statistically significant(P<0.05), and the Scr and BUN levels in the observation group in 1 month after surgery were lower than those in the control group, [(108.52±31.65)μmo L、(4.35±1.06)mmol/L vs(133.34±38.79)μmo L、(6.72±1.19)mmol/L], and the differences were statistically significant(P <0.05). Conclusion The detritus success rate and stone free rate of holmium laser lithotripsy are higher than those of ballistic lithotripsy in treatment of catheter stones with small injury to ureter and mild stress reactions, which is conducive to improving the renal function indexes of patients, and it can be used as the first choice of clinical treatment of ureteral calculus.

关 键 词：输尿管镜下钬激光碎石术 输尿管结石 应激反应 肾功能 

分 类 号：R3[医药卫生—基础医学]