炎性因子检测与肾盂输尿管连接部梗阻手术治疗的临床研究  

Clinical study on detection of inflammatory factors and surgical treatment of obstruction of pelvic ureteral junction

作　　者：颜冰 孙毅海 何文军[3] 黄恒前[3] YAN Bing;SUN Yihai;HE Wenjun;HUANG Hengqian(Department of Urology,the Third People′s Hospital of Nanning,Guangxi Zhuang Autonomous Region,Nanning530003,China;Department of Urology,the Third Affiliated Hospital of Guangxi Medical University,Guangxi Zhuang Autonomous Region,Nanning530031,China;Department of Urology,the First People′s Hospital of Nanning,Guangxi Zhuang Autonomous Region,Nanning530022,China)

机构地区：[1]广西壮族自治区南宁市第三人民医院泌尿外科,广西南宁530003 [2]广西医科大学第三附属医院泌尿外科,广西南宁530031 [3]广西壮族自治区南宁市第一人民医院泌尿外科,广西南宁530022

出　　处：《中国医药导报》2020年第9期65-68,共4页China Medical Herald

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(原广西壮族自治区卫生厅自筹经费科研课题)(Z2006278)。

摘　　要：目的回顾分析不同手术方式治疗肾盂输尿管连接部梗阻(UPJO)对各炎性因子检测指标的影响。方法选取2014年1月~2019年6月于广西壮族自治区南宁市第一人民医院泌尿外科收治的单侧病变UPJO患者89例。以手术方式进行分组,采用腹膜后腹腔镜手术作为实验组(45例),开放性手术作为对照组(44例)。比较两组患者手术前后C-反应蛋白(CRP)、降钙素原(PCT)、白细胞计数等炎性因子检测指标。结果两组患者术前CRP、PCT、白细胞计数比较,差异无统计学意义(P>0.05)。两组患者术后CRP、PCT、白细胞计数均高于术前,且实验组低于对照组,差异有统计学意义(P<0.05或P<0.01)。术后两组患者尿液细菌培养阳性人数比较,差异无统计学意义(P>0.05)。结论UPJO手术创伤均会造成应激炎性反应,引起炎性因子升高。而腹膜后腹腔镜手术引起炎性因子升高明显低于开放手术,较开放手术有优势,可为临床手术方案选择提供一定的参考依据。Objective To retrospectively analyze the effects of different surgical methods for treating the ureteropelvic junction obstruction(UPJO)on the detection indexes of various inflammatory factors.Methods From January 2014 to June 2019,a total of 89 patients with unilateral lesions of UPJO in Department of Urology of the First People′s Hospital of Naning were selected.Grouped according to the surgical method,retroperitoneal laparoscopy was used as the experimental group(45 cases),while open surgery was used as the control group(44 cases).Detection indexes of inflammatory factors such as C-reactive protein(CRP),procalcitonin(PCT),and white blood cell count of patients were compared between the two groups.Results There was no significant difference in CRP,PCT,and white blood cell count of patients between the two groups before surgery(P>0.05).CRP,PCT,and white blood cell counts in the two groups after surgery were higher than those before surgery,while those in the experimental group were lower than those in the control group,and the differences were statistically significant(P<0.05 or P<0.01).There was no significant difference in the number of positive urine cultures of patients between the two groups after surgery(P>0.05).Conclusion UPJO surgical trauma can cause stress inflammatory response,causing increased inflammatory factors.However,the increase of inflammatory factors caused by retroperitoneal laparoscopy is significantly lower than that of open surgery,which has advantages over open surgery.It can provide a certain reference for the selection of clinical surgery plan.

关 键 词：腹腔镜手术 开放性手术 肾盂输尿管连接部梗阻 C-反应蛋白 降钙素原 白细胞 

分 类 号：R692.7[医药卫生—泌尿科学]