低肾盂压力在输尿管软镜碎石术治疗上尿路结石中的效果分析  

Effects of low renal pelvis pressure in patients with upper urinary tract calculi treated with flexible ureteroscopic lithotripsy

作　　者：李东风[1] 陈燕忠[1] 韩军[1] Li Dongfeng;Chen Yanzhong;Han Jun(Department of Urology,Kunshan Third People’s Hospital,Suzhou 215316,Jiangsu,China)

机构地区：[1]昆山市第三人民医院泌尿外科,江苏苏州215316

出　　处：《泌尿外科杂志（电子版）》2022年第2期92-95,共4页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的探究低肾盂压力在输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)治疗上尿路结石中的效果。方法选取2017年6月至2021年6月期间昆山市第三人民医院收治的106例上尿路结石患者,所有患者均行FURL,并于术中监测肾盂压力,根据术中肾盂压力的不同将患者分为高压组55例(肾盂压力≥30 mmHg),低压组51例(肾盂压力<30 mmHg)。比较两组患者术前1 d、术后3 d的肾功能指标[血肌酐(serum creatinine,Scr)、尿素氮(blood urea nitrogen,BUN)]、炎症指标[白细胞介素6(interleukin 6,IL-6)、C反应蛋白(C-reactive protein,CRP)]及氧化应激指标[超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)],并统计术后并发症发生情况,分析其安全性。结果术后3 d,两组患者Scr、BUN水平均升高,但低压组Scr、BUN水平低于高压组(P<0.05);两组患者IL-6、CRP水平均升高,但低压组IL-6、CRP水平低于高压组(P<0.05);两组患者SOD水平降低、MDA水平升高,但低压组SOD水平高于高压组,MDA水平低于高压组(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05);低压组患者住院时间低于高压组(P<0.05);高压组患者出现发热4例,细菌感染6例,肾区痛3例,腹腔积液1例,低压组出现发热、细菌感染各2例,肾区痛1例,低压组术后并发症总发生率为9.80%低于高压组的25.45%(P<0.05)。结论与高肾盂压力比较,上尿路结石患者在FURL中低肾盂压力能够降低对肾功能损伤,减少对炎症水平及氧化应激指标的激活作用,降低术后并发症的发生率,因此控制肾盂压力于低水平对FURL具有重要意义。Objective This study aimed to investigate the effects of low renal pelvis pressure in patients with upperurinary calculi treated with flexible ureteroscopic lithotripsy(FURL).Methods A total of106 patients with upperurinary calculi admitted to the Third People’s Hospital of Kunshan City between June 2017 and June 2021 were selected.All patients underwent FURL,and renal pelvis pressure was monitored during the operation.According to the intraoperative renal pelvis pressure,the patients were divided into a high pressure group(55 cases,renal pelvis pressure≥30 mmHg)and a low pressure group(51 cases,renal pelvis pressure<30 mmHg).Renal function indexes[serum creatinine(Scr)and blood urea nitrogen(BUN)],inflammatory indexes[interleukin-6(IL-6)and C-reactive protein(CRP)]and oxidative stress indicators[superoxide dismutase(SOD)and malondialdehyde(MDA)],and the incidence of postoperative complications were analyzed to assesssafety.Results On the 3 rd day after operation,Scr and BUN levels in both groups increased,but Scr and BUN levels in the low-pressure group were lower than those in the low-pressure group(P<0.05).The levels of IL-6 and CRP in both groups increased butwere lower in the low pressure group than the high pressure group(P<0.05).The SOD level decreased,and the MDA level increased in both groups,but the SOD level in the low pressure group was higher than that the low pressure group,and the MDA level was lower than that in the high pressure group(P<0.05).No significant difference in operation time was observed between the high and low pressure groups(P>0.05),and the hospitalization time was shorter in the low pressure group than the high pressure group(P<0.05).There were four cases of fever,sixcases of bacterial infection,three cases of renal pain and one case of ascites in the high pressure group,and two cases of fever,two cases of bacterial infection,and one case of renal pain in the low pressure group.The total incidence of postoperative complications was lower in the low pressure group was9.80%,a val

关 键 词：肾盂压力 输尿管软镜碎石术 上尿路结石 肾功能 

分 类 号：R364.2[医药卫生—病理学]