标准经皮肾镜联合膀胱软镜治疗肾结石对血清Hcy、β2MG的影响  

Effect of standard percutaneous nephroscope combined with bladder soft lens lithotomy in the treatment of serum Hcy, β2MG in kidney stone

作　　者：高琳[1] 谷玉峰 宋洪明 李传贵 Gao Lin;Gu Yufeng;Song Hongming;et al.(Department of Urology, Eighty - eighth Hospital of Tai＇an Liberation Army, Shandong 271000,China)

机构地区：[1]泰安泰安解放军第88医院泌尿科,山东271000

出　　处：《国际泌尿系统杂志》2018年第3期399-403,共5页International Journal of Urology and Nephrology

摘　　要：目的 探讨标准经皮肾镜联合膀胱软镜取石术治疗肾结石对血清同型半胱氨酸（homocysteineHcy）、β2-微球蛋白（beta 2-microglobulin,β2MG）的影响.方法 选取2013年12月至2016年12月期间在本院确诊治疗的肾结石患者100例,依据随机分配原则分为双镜组和肾镜组,各组50例.肾镜组给予标准经皮肾镜取石术（percutaneous nephrolithotomy,PCNL）治疗,双镜组给予标准经皮肾镜联合膀胱软镜取石术治疗.统计分析所有患者术中出血量、手术、肠功能恢复、住院时间、一期结石清除、并发症情况及治疗前后疼痛、血清Hcy、β2MG水平.结果 双镜组术中出血量、肠功能恢复、住院时间、并发症发生率明显低于肾镜组;双镜组一期结石清除率、手术时间明显高于肾镜组,差异具有统计学意义（P〈0.05）;双镜组和肾镜组治疗后第1天、第4天的视觉模拟评分法（visual analogue score,VAS）得分、血清Hcy水平较治疗前下降,血清β2MG水平较治疗前升高,血清Hcy水平变化更显著,差异具有统计学（P〈0.05）.结论 标准经皮肾镜联合膀胱软镜取石术可提高肾结石患者的治疗疗效及减少手术创伤、并发症发生,并能改善血清Hcy、β2MG水平,有利于患者疼痛缓解、术后恢复,但仍需进一步提高相关操作技术.Objective To discuss the effect of standard percutaneous nephroscope combined with bladder soft lens lithotomy in the treatment of serum homocysteine （Hcy）,beta 2-microglobulin （β2MG） in kidney stone.Methods A total of 100 patients with kidney stone were selected from December 2013 to December 2016 in our hospital,and all patients were randomly divided into double lens and renal lens group,50 cases in each group,renal lens group was given standard percutaneous nephrolithotomy （PCNL） treatment,the double lens group was given standard percutaneous nephroscope combined with bladder soft lens lithotomy treatment.Intraoperative blood loss,operation,bowel function recovery,length of hospital stay,the issue of stone removal,complications and pain before and after treatment,serum Hcy,β2MG levels were statistical analyzed.Results The intraoperative blood loss,bowel function recovery,length of hospital stay,the incidence of complication of double lens group were significantly lower than thosed of renal lens group,the first phase stone clearance rate,operation time of the former were significantly higher than those of the latter,the differences were statistically significant （P 〈 0.05）.The 1,4 d after treatment,VAS scores,serum Hcy levels of double lens and renal lens group compared with before treatment were increased,the serum β2MG level was increased,but the change of former was significantly more than that of the latter,the difference was statistically significant （P 〈 0.05）.Conclusions Standard percutaneous nephroscope combined with bladder soft lens lithotomy can improve the treatment of patients with kidney stones and reduce complications and surgical trauma,and it can improve the level of serum Hcy,β2MG,it is beneficial to patients ＇pain relief,recovery,but it still need to improve the relevant operation technology.

关 键 词：肾结石 肾造口术 经皮 膀胱镜 Β2微球蛋白 

分 类 号：R699.2[医药卫生—泌尿科学]