经尿道输尿管镜碎石术与微创经皮肾镜取石术治疗嵌顿性输尿管上段结石疗效比较  

Comparison of curative effect between transurethral ureteroscopic lithotripsy and minimally invasive percutaneous nephrolithotomy for incarcerated upper ureteral calculi

作　　者：高为 张启旺[1] 柯磊磊 疏仁义[1] GAO Wei;ZHANG Qiwang;KE Leilei;SHU Renyi(Department of Urology,the People′s Hospital of Chizhou,Chizhou 247000,Anhui Province,China)

机构地区：[1]池州市人民医院泌尿外科,安徽池州247000

出　　处：《新乡医学院学报》2022年第5期465-469,共5页Journal of Xinxiang Medical University

摘　　要：目的比较经尿道输尿管镜碎石术(URL)与微创经皮肾镜取石术(MPCNL)治疗嵌顿性输尿管上段结石的临床效果。方法选择2018年3月至2020年12月池州市人民医院收治的64例嵌顿性输尿管上段结石患者为研究对象,根据治疗方法将患者分为URL组(30例)和MPCNL组(34例)。比较2组患者的手术时间、术中出血量、住院时间、结石清除率及并发症;分别于术前及术后第1、5天检测2组患者血清炎症因子降钙素原(PCT)、白细胞介素-6(IL-6)和应激反应指标丙二醛(MDA)、超氧化物歧化酶(SOD)水平,并进行比较。结果URL组患者的手术时间显著短于MPCNL组,术中出血量显著少于MPCNL组(P<0.05),2组患者的住院时间比较差异无统计学意义(P>0.05)。URL组和MPCNL组患者的结石清除率分别为66.67%(20/30)、88.24%(30/34),URL组患者的结石清除率显著低于MPCNL组(χ^(2)=4.338,P<0.05)。2组患者术前血清PCT和IL-6水平比较差异无统计学意义(P>0.05)。2组患者术后第1天血清PCT和IL-6水平显著高于术前,术后第5天血清PCT和IL-6水平显著低于术后第1天(P<0.05);MPCNL组患者术后第5天血清PCT和IL-6水平显著高于术前(P<0.05),URL组患者术后第5天与术前血清PCT和IL-6水平比较差异无统计学意义(P>0.05)。术后第1、5天,URL组患者血清PCT和IL-6水平显著低于MPCNL组(P<0.05)。2组患者术前血清MDA、SOD水平比较差异无统计学意义(P>0.05)。与术前比较,2组患者术后第1天血清MDA水平显著升高,血清SOD水平显著降低(P<0.05);与术后第1天比较,2组患者术后第5天血清MDA水平显著降低,血清SOD水平显著升高(P<0.05);2组患者术后第5天血清MDA水平显著高于术前,血清SOD水平显著低于术前(P<0.05)。术后第1、5天,URL组患者血清MDA水平显著低于MPCNL组,血清SOD水平显著高于MPCNL组(P<0.05)。URL组和MPCNL组患者并发症发生率分别为10.00%(3/30)、11.76%(4/34),2组患者并发症发生率比较差异无统计学�Objective To compare the curative effect between transurethral ureteroscopic lithotripsy(URL)and minimally invasive percutaneous nephrolithotomy(MPCNL)in the treatment of incarcerated upper ureteral calculi.Methods A total of 64 patients with incarcerated upper ureteral calculi admitted to the People′s Hospital of Chizhou from March 2018 to December 2020 were selected as the research subjects,and the patients were divided into URL group(n=30)and MPCNL group(n=34)according to the treatment method.The operation time,intraoperative bleeding,hospitalization time,stone clearance rate and complications were compared between the two groups.The levels of serum inflammatory factors procalcitonin(PCT),interleukin-6(IL-6)and stress response indexes malondialdehyde(MDA),superoxide dismutase(SOD)were detected and compared before operation and on the first and fifth day after operation,respectively.Results The operation time of patients in the URL group was significantly shorter than that in the MPCNL group,and the intraoperative bleeding was significantly less than that in the MPCNL group(P<0.05).There was no significant difference in hospitalization time between the two groups(P>0.05).The stone clearance rate of patients in the URL group and MPCNL group was 66.67%(20/30)and 88.24%(30/34),respectively.The stone clearance rate of patients in the URL group was significantly lower than that in the MPCNL group(χ^(2)=4.338,P<0.05).There was no significant difference in the levels of serum PCT and IL-6 between the two groups before operation(P>0.05).The levels of serum PCT and IL-6 on the first day after operation were significantly higher than those before operation,and the levels of serum PCT and IL-6 on the fifth day after operation were significantly lower than those on the first day after operation in the two groups(P<0.05).The levels of serum PCT and IL-6 on the fifth day after operation were significantly higher than those before operation in the MPCNL group(P<0.05).There was no significant difference in the levels of ser

关 键 词：嵌顿性输尿管上段结石 经尿道输尿管镜碎石术 微创经皮肾镜取石术 降钙素原 白细胞介素-6 丙二醛 超氧化物歧化酶 

分 类 号：R693.4[医药卫生—泌尿科学]