复杂肾结石患者行经皮肾镜、输尿管软镜单一及联合治疗效果、炎症指标及安全性对比研究  

A comparative study on the efficacy,inflammatory indexes and safety of single and combined treatment of percutaneous nephroscopy and flexible ureteroscopy in patients with complex kidney stones

作　　者：刘旭东 杜勇[1] 李志远[1] 何正宇 LIU Xu-dong;DU Yong;LI Zhi-yuan;HE Zheng-yu(Ya′an People′s Hospital, Ya′an 625000, China)

机构地区：[1]四川省雅安市人民医院,四川雅安625000

出　　处：《实用医院临床杂志》2022年第4期102-105,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析复杂肾结石患者行经皮肾镜、输尿管软镜单一及结合治疗的临床效果。方法2016年1月至2020年12月我院收治的复杂肾结石患者158例。根据医嘱及患者意愿选择治疗方式,分为经皮组(经皮肾镜)49例、软镜组(输尿管软镜钬激光碎石术)53例与联合组(经皮肾镜+输尿管软镜)56例。对比各组临床指标、清石率及治疗后1个月肾功能指标、炎症指标、并发症情况。结果联合组手术时间、术中出血量、排气时间、住院时间均少于经皮组,多于软镜组;清石率高于经皮组及软镜组(P<0.05);治疗后各组肾功能指标水平均降低,联合组血肌酐、血尿素氮、胱抑素C低于经皮组及软镜组,以经皮组最高(P<0.05);治疗后各组降钙素原(PCT)、白细胞介素(IL)-13、高敏C反应蛋白(hs-CRP)水平升高,联合组治疗后PCT、IL-13、hs-CRP水平高于软镜组,但低于经皮组(P<0.05);三组间并发症情况比较,联合组与经皮组明显低于软镜组(P<0.05),联合组与经皮组比较差异无统计学意义(P>0.05)。结论复杂性肾结石通过经皮肾镜联合输尿管软镜治疗效果优于两者单一治疗,可减少肾功能损伤,促进患者恢复,具有较高的临床使用价值。Objective To analyze the clinical effects of percutaneous nephrolithiasis and flexible ureteroscope single and combined treatment in patients with complex kidney stones.Methods One hundred and fifty-eight patients with complicated kidney stones admitted to our hospital from January 2016 to December 2020 were collected.According to the doctor’s order and the patient’s wishes,the patients was divided into a percutaneous group treated with percutaneous nephroscopy(n=49),a flexible ureteroscopy group treated with flexible ureteroscope and holmium laser lithotripsy(n=53),and a combined group treated with percutaneous nephroscope+flexible ureteroscopy(n=56).The clinical indicators and stone removal rate,as well as renal function indicators,inflammation indicators and complications were compared after one month of treatment among the groups.Results The operation time,exhaust time and hospital stay in the combined group were shorter than those in the percutaneous group,but longer than those in the flexible ureteroscopy group(P<0.05).The stone removal rate in the combined group was higher than that of the percutaneous and the flexible ureteroscopy groups(P<0.05).The levels of renal function indexes in each group were decreased.The levels of creatinine(Scr),blood urea nitrogen(BUN),and cystatin C(CysC)of the combined group were significantly lower than those of the percutaneous group and the flexible ureteroscopy group,and the percutaneous group was the highest(P<0.05).After treatment,the levels of procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),and interleukin-13(IL-13)of each group were increased.The levels of PCT,IL-13,and Hs-CRP of the combined group was higher than that in the flexible ureteroscopy group,but significantly lower than that in the percutaneous group(P<0.05).There were differences in the complications among the three groups,and the combined group and the percutaneous group were significantly lower than the flexible ureteroscopy group(P<0.05),but there was no difference between the combi

关 键 词：复杂肾结石 经皮肾镜 输尿管软镜 治疗疗效 炎症指标 安全性 

分 类 号：R699.2[医药卫生—泌尿科学]