输尿管软镜钬激光碎石术与经皮肾镜碎石术治疗肾结石的临床效果及对肾功能的影响  

Clinical Effect of Flexible Ureteral Holmium Laser Lithotripsy and Percutaneous Nephrolithotomy in the Treatment of Renal Calculi and Its Effect on Renal Function

作　　者：叶韬[1] 李成文[1] 高加胜[1] 张海峰 李志坚[1] YE Tao;LI Chengwen;GAO Jiasheng;ZHANG Haifeng;LI Zhijian(The First People’s Hospital of Jiujiang City,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2020年第30期19-22,共4页Medical Innovation of China

基　　金：九江市科技计划项目(2017101)。

摘　　要：目的:探讨输尿管软镜钬激光碎石术(FURL)与经皮肾镜碎石术(PCNL)治疗肾结石的临床效果及对肾功能的影响。方法:选择2017年4月-2019年8月本院收治的肾结石患者84例,按随机数字表法分为两组,各42例。试验组行FURL术,对照组行PCNL术。比较两组手术相关指标、应激反应、肾功能及并发症。结果:试验组、对照组一期结石清除率分别为88.10%、92.86%,两组比较差异无统计学意义(P>0.05);试验组术中出血量、术后止痛药物使用次数均少于对照组,手术时间长于对照组,术后住院时间短于对照组,术后去甲肾上腺素(NE)、皮质醇(Cor)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)水平均低于对照组,差异均有统计学意义(P<0.05);两组肌酐(Cr)、尿素氮(BUN)水平、术后并发症发生率比较,差异均无统计学意义(P>0.05)。结论:FURL、PCNL均是治疗肾结石的有效方式,其中FURL对机体造成的损伤较小,能减轻手术应激损伤和术后疼痛程度,对肾功能影响较小,可缩短术后住院时间。Objective:To investigate the clinical efficacy of flexible ureteral holmium laser lithotripsy(FURL)and percutaneous nephrolithotomy(PCNL)in the treatment of renal calculi and the effect on renal function.Method:Eighty-four patients with renal calculi treated in our hospital from April 2017 to August 2019 were selected and divided into two groups according to the random number table method,42 patients in each group.The experimental group received FURL and the control group received PCNL.The surgical related indicators,stress response,renal function and complications were compared between two groups.Result:The first-stage stone removal rates in the experimental group and the control group were 88.10%and 92.86,respectively,and there was no significant difference between two groups(P>0.05).The blood loss during the operation and the number of postoperative pain medications in the experimental group were lower than those in the control group,the operation time was longer than that in the control group,and the postoperative hospital stay was shorter than that in the control group,the norepinephrine(NE),cortisol(Cor),and neutrophil gelatinase-associated lipocalin(NGAL)levels after operation were lower than those in the control group,there were significant differences(P<0.05).There were no significant differences in the levels of creatinine(Cr)and urea nitrogen(BUN)and the incidence of postoperative complications in two groups(P>0.05).Conclusion:Both FURL and PCNL are effective ways to treat kidney stones.Among them,FURL causes less damage to the body,can reduce surgical stress injury and postoperative pain,has less impact on renal function,and can shorten postoperative hospital stay.

关 键 词：肾结石 输尿管软镜钬激光碎石术 经皮肾镜碎石术 应激反应 并发症 

分 类 号：R699.2[医药卫生—泌尿科学]