硕通镜联合SMP治疗复杂输尿管上段及肾结石患者的疗效及影响  

Efficacy of Shuotong Mirror Combined with SMP in the Treatment of Complex Upper Ureteral and Renal Stones and its Effect on Renal Function

作　　者：郭前进[1] 何文强 Guo Qianjin;He Wenqiang(Xihua County People’s Hospital,Zhoukou,Henan,466600,China)

机构地区：[1]西华县人民医院,河南周口466600

出　　处：《黑龙江医学》2023年第23期2841-2843,共3页Heilongjiang Medical Journal

摘　　要：目的:探究硕通镜联合超微通道经皮肾镜取石术(SMP)治疗复杂输尿管上段及肾结石患者疗效及对炎性介质、肾功能指标及安全性的影响。方法:选取2019年12月—2022年1月西华县人民医院收治的98例复杂输尿管上段及肾结石患者作为研究对象,随机将患者分为联合组(n=49,给予硕通镜联合SMP)和常规组(n=49,给予传统取石术)。观察结石清除效果、手术指标及安全性,对比术前及术后3 d炎性介质[白介素(IL-6)、单核细胞趋化蛋白-1(MCP-1)、C反应蛋白(CRP)]、肾功能指标[肾损伤分子-1(KIM-1)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、β_(2)-微球蛋白(β_(2)-MG)]。结果:术后,联合组患者1次结石清除率高于常规组,差异有统计学意义(χ^(2)=6.376,P<0.05);联合组患者首次下床时间、住院时间短于常规组,差异有统计学意义(t=3.562、2.172,P<0.05);联合组患者CRP、MCP-1、IL-6低于常规组,差异有统计学意义(t=3.428、3.010、2.135,P<0.05);联合组患者KIM-1、NGAL、β2-MG低于常规组,差异有统计学意义(t=3.608、3.003、3.440,P<0.05);联合组患者并发症发生情况低于常规组,差异有统计学意义(χ^(2)=4.356,P<0.05)。结论:硕通镜联合SMP治疗复杂输尿管上段及肾结石能优化手术路径,提高短期疗效,减轻炎性反应,有助于保护肾功能,提高治疗安全性。Objective:To investigate the efficacy and effect on inflammatory mediators,renal function indices,and safety of Shuotong mirror combined with ultramicrochannel percutaneous nephrolithotripsy(SMP)in the treatment of patients with complex upper ureteral and renal stones.Methods:98 patients with complex upper ureteral and renal stones admitted to the hospital from December 2019 to January 2022 were selected for the study,and the patients were randomly divided into the combined group(n=49,given Shuotong mirror combined with SMP)and the conventional group(n=49,given conventional lithotripsy).The stone removal effect,surgical indexes and safety were observed.The preoperative and 3 d postoperative inflammatory mediators(interleukin[IL-6],monocyte chemotactic protein-1[MCP-1],C-reactive protein[CRP]),renal function indexes(kidney injury molecule-1[KIM-1],neutrophil gelatinase-associated lipid transport protein[NGAL],andβ_(2)-microglobulin[β_(2)-MG])were compared.Results:Postoperatively,the 1-time stone clearance rate of patients in the combined group was higher than that of the conventional group,and the difference was statistically significant(χ^(2)=6.376,P<0.05).The first time out of bed and hospitalization time of patients in the combined group were shorter than those in the conventional group,and the differences were statistically significant(t=3.562,2.172,P<0.05).Patients in the combined group had lower CRP,MCP-1,and IL-6 than those in the conventional group,and the difference was statistically significant(t=3.428,3.010,2.135,P<0.05).Patients in the combined group had lower KIM-1,NGAL,andβ2-MG than those in the conventional group,and the difference was statistically significant(t=3.608,3.003,3.440,P<0.05).The occurrence of complications in patients in the combined group was lower than that in the conventional group,and the difference was statistically significant(χ^(2)=4.356,P<0.05).Conclusion:Shuotong mirror combined with SMP for the treatment of complex upper ureteral and renal stones optimizes the surgical p

关 键 词：输尿管上段 肾结石 硕通镜 超微通道 经皮肾镜取石术 

分 类 号：R692.4[医药卫生—泌尿科学]