微创经皮肾镜钬激光碎石术对复杂性肾结石患者血清及尿液肾损伤指标的影响研究  

Effects of Minimally Invasive Transdermal Kidney Mirror Laser Gravel on Serum and Urine Renal Injury Index of Patients with Complex Kidney Stones

作　　者：何青松 谢永煌 黄德勇 朱旻 HE Qingsong;XIE Yonghuang;HUANG Deyong;ZHU Min(Enshi Central Hospital,Hubei Province,Enshi 445000,China;不详)

机构地区：[1]湖北省恩施市中心医院,湖北恩施445000

出　　处：《中国医学创新》2022年第12期30-34,共5页Medical Innovation of China

摘　　要：目的:分析对复杂性肾结石患者实施微创经皮肾镜钬激光碎石术的相关影响。方法:选取2019年12月-2020年12月恩施市中心医院收治的80例复杂性肾结石患者,按照随机数字表法将其分为研究组和对照组,每组40例。对照组实施肾切开取石术治疗,研究组实施微创经皮肾镜钬激光碎石术。比较两组结石清除率、手术相关指标、血清及尿液肾损伤指标[胱抑素C(Cys C)、β;微球蛋白(β;-MG)、血尿素氮(BUN)、血肌酐(Scr)、肾损伤分子-1(KIM-1)]、炎症指标[降钙素原(PCT)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、应激指标[皮质醇(Cor)、去甲肾上腺素(NE)、超氧化物歧化酶(SOD)]。结果:术后1个月,两组结石清除率比较,差异无统计学意义(P>0.05)。研究组手术时间、术后住院时间及下床活动时间均短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05)。术前,两组Cys C、β;-MG、BUN、Scr、KIM-1水平比较,差异均无统计学意义(P>0.05);术后,两组Cys C、β;-MG、BUN、Scr、KIM-1水平均高于术前,且研究组均低于对照组,差异均有统计学意义(P<0.05)。术前,两组SOD、NE、Cor、IL-6、TNF-α、PCT水平比较,差异均无统计学意义(P>0.05);术后,两组SOD均低于术前,NE、Cor、IL-6、TNF-α、PCT均高于术前,且研究组SOD高于对照组,NE、Cor、IL-6、TNF-α、PCT均低于对照组,差异均有统计学意义(P<0.05)。结论:对于复杂性肾结石患者而言,为其实施的两种手术方式均可获得较高的结石清除率,但相比于肾切开取石术治疗,微创经皮肾镜钬激光碎石术对患者术后肾损伤指标、炎症、应激指标等造成的影响更小,更有利于患者的术后恢复,具有更高的临床应用价值。Objective:To analyze the impact of minimally invasive transdermal kidney mirror laser gravel for patients with complex kidney stones.Method:A total of 80 patients with complex kidney stones admitted to Enshi Central Hospital from December 2019 to December 2020 were selected,they were divided into study group and control group according to random number table method,with 40 cases in each group.Nephrotomy and lithotripsy were performed in the control group and minimally invasive transdermal kidney mirror laser gravel was performed in the study group.Stone clearance rate,surgical related indexes,serum and urine renal injury indexes[Cystatin C (Cys C),β;-microglobulin (β;-MG),blood urea nitrogen (BUN),serum creatinine (Scr),kidney injury molecule-1 (KIM-1)],inflammatory index[procalcitonin (PCT),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α)]and stress index[cortisol (Cor),norepinephrine (NE),superoxide dismutase (SOD)]were compared between two groups.Result:1 month after surgery,there was no significant difference in stone clearance rate between two groups (P>0.05).The operative time,postoperative hospitalization time and ambulation time of the study group were shorter than those of the control group,and the intraoperative blood loss of the study group was less than that of the control group,the differences were statistically significant (P<0.05).Before surgery,there were no significant differences in the levels of Cys C,β;-MG,BUN,Scr and KIM-1 between two groups (P>0.05);after surgery,the levels of Cys C,β;-MG,BUN,Scr and KIM-1 of both groups were higher than those before surgery,and those of the study group were lower than those of the control group,the differences were statistically significant (P<0.05).Before surgery,there were no significant differences in SOD,NE,Cor,IL-6,TNF-α and PCT levels between two groups (P>0.05);after surgery,SOD of both groups were lower than those before surgery,NE,Cor,IL-6,TNF-α and PCT of both groups were higher than before surgery,and SOD of the study group was higher

关 键 词：微创经皮肾镜钬激光碎石术 复杂性肾结石 肾损伤指标 炎症指标 应激指标 

分 类 号：R699.2[医药卫生—泌尿科学]