输尿管软镜在孤立肾鹿角状结石治疗中的临床研究  

Clinical research on flexible ureteroscope in the treatment of solitary renal staghorn calculi

作　　者：刘小勇[1] 向宸辉[1] 陈胜龙[1] 

机构地区：[1]成都医学院第一附属医院泌尿外科,四川成都610500

出　　处：《实用医院临床杂志》2017年第6期140-143,共4页Practical Journal of Clinical Medicine

摘　　要：目的探讨输尿管软镜(FUS)治疗孤立肾鹿角状结石(solitary renal staghorn calculi,SRSC)的效果。方法 2014年1月至2016年12月我院治疗的SRSC患者64例,依据随机数字表法分为FUS组和经皮肾镜碎石取石术(PCNL)组各32例。PCNL组行PCNL治疗,FUS组行FUS治疗。比较两组手术时间、术后排气时间、住院时间、术后血红蛋白降低值、一期结石清除率、并发症情况及术后1周血清CD3^+、CD4^+、CD8^+、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平。结果 FUS组手术时间长于PCNL组,术后排气时间、血红蛋白降低值、住院时间、并发症发生率低于PCNL组,差异有统计学意义(P<0.05)。两组结石总清除率差异无统计学意义(P>0.05)。FUS组术后1周CD3^+、CD4^+、CD8^+及CRP、TNF-α、IL-6差值均大于PCNL组(P<0.05)。结论 FUS治疗SRSC可达到清除结石的目的,且可快速纠正免疫失衡,降低炎性反应,安全可靠,值得临床应用。Objective To investigate the clinical effect of flexible ureteroscope （FUC） in the treatment of solitary renal staghorn calculi （SRSC）. Methods A total of 64 SRSC patients admitted and treated in our hospital from January 2014 to December 2016 were divided into FUS or percutaneous nephrolithotomy （PCNL） group according to the random number table,32 in each group. Pa- tients in the two groups were treated with FUS and PCNL, respectively. The time of operation, anus exhausting time after operation, hospitalized time,postoperative hemoglobin decrease, primary stone clearance rate, postoperative complication rates, and serum levels of CD3^＋, CD4^＋, CD8^＋, CRP,TNF-α and IL-6 before and after the treatment were compared between the two groups. Results The time of operation of patients in the FUS group was longer but the anus exhausting time after operation,hospitalized time, postoperative hemoglobin decrease and complication rate were shorter or less in the FUS group than those in the PCNL group （ P 〈 0. 05 ）. The total clearance rate was not statistically significant between the two groups （ P 〉 0.05 ）. Differences in serum levels of CD3^＋, CD4^＋, CD8^＋, CRP, TNF-α and IL-6 before and after treatment was larger in the FUS group than that in the PCNL group after one week of operation （P 〈 0. 05）. Conclusion The FUS can remove the stones and revise the immune imbalance rapidly to reduce the inflammatory reaction in the treatment of SRSC patients. It is safe and reliable and worth of application clinically.

关 键 词：输尿管软镜 孤立肾 鹿角状结石 治疗 

分 类 号：R692.4[医药卫生—泌尿科学]