MPCNL治疗嵌顿性输尿管结石的效果及对炎症反应、复发率的影响  

Effect of MPCNL in the Treatment of Impacted Ureteral Calculus and Its Influence on Inflammatory Reaction and Recurrence Rate

作　　者：乐志文 张文圣[1] 李勋钢[1] 曾加 万滨[1] LE Zhiwen;ZHANG Wensheng;LI Xungang;ZENG Jia;WAN Bin(Department of Urology,Jiujiang NO.1 People's Hospital,Jiujiang 332001,China;不详)

机构地区：[1]九江市第一人民医院泌尿外科,江西九江332001

出　　处：《中国医学创新》2024年第18期1-5,共5页Medical Innovation of China

基　　金：2022年度市级指导性科技计划项目(S2022ZDYFN259)。

摘　　要：目的:探讨微创经皮肾镜碎石取石术(MPCNL)治疗嵌顿性输尿管结石的效果及对炎症反应、复发率的影响。方法:选取2021年1月—2022年12月九江市第一人民医院收治的95例嵌顿性输尿管结石患者,按照随机数字表法分为对照组(n=45,经尿道输尿管软镜碎石术)和研究组(n=50,MPCNL)。比较两组结石清除率、恢复效果(术中出血量、术后并发症、住院时间)、复发率、炎症反应指标[C反应蛋白(CRP)、白细胞介素(interleukin,IL)-1β、降钙素原(PCT)]及氧化应激指标[过氧化氢酶(CAT)、丙二醛(MDA)、晚期氧化蛋白产物(AOPP)]。结果:研究组术后3 d、1个月的结石清除率分别为98.00%、100%,均高于对照组的82.22%、86.67%,差异均有统计学意义(P<0.05)。研究组复发率为2.00%,低于对照组的17.95%,差异有统计学意义(P<0.05)。研究组术中出血量多于对照组,住院时间长于对照组,差异均有统计学意义(P<0.05)。研究组术后并发症发生率为8.00%,与对照组的4.44%比较,差异无统计学意义(P>0.05)。术前,两组CRP、IL-1β、PCT、CAT、MDA、AOPP水平比较,差异均无统计学意义(P>0.05);术后3 d,研究组CAT水平高于对照组,其余各指标水平均低于对照组,差异均有统计学意义(P<0.05)。结论:MPCNL治疗嵌顿性输尿管结石虽然会在一定程度上增加术中出血量,延长住院时间,但可提高结石清除率,降低复发率,减轻炎症反应及氧化应激,且不会增加术后并发症的发生。Objective:To investigate the effect of minimally percutaneous nephrolithotomy(MPCNL)in the treatment of impacted ureteral calculus and its influence on inflammatory reaction and recurrence rate.Method:A total of 95 patients with impacted ureteral calculus admitted to Jiujiang NO.1 People's Hospital from January 2021 to December 2022 were selected and divided into control group(n=45,transurethral ureteroscopic lithotripsy)and study group(n=50,MPCNL)according to random number table method.The stone clearance rate,recovery effect(intraoperative bleeding volume,postoperative complications,hospital stay),recurrence rate,inflammatory reaction indexes[C reactive protein(CRP),interleukin(IL)-1β,procalcitonin(PCT)]and oxidative stress indexes[catalase(CAT),malondialdehyde(MDA),advanced oxidation protein products(AOPP)]were compared between the two groups.Result:The stone clearance rates of the study group were 98.00%and 100%at 3 days and 1 month after surgery,respectively,which were higher than 82.22%and 86.67%of the control group,the differences were statistically significant(P<0.05).The recurrence rate of the study group was 2.00%,which was lower than 17.95%of the control group,the difference was statistically significant(P<0.05).The intraoperative bleeding volume in the study group was more than that in the control group,and the hospital stay was longer than that in the control group,the differences were statistically significant(P<0.05).The incidence of postoperative complications in the study group was 8.00%,compared with 4.44%in the control group,the difference was not statistically significant(P>0.05).Before surgery,there were no significant differences in the levels of CRP,IL-1β,PCT,CAT,MDA and AOPP between the two groups(P>0.05).3 days after surgery,the CAT level of the study group was higher than that of the control group,and the other indexes were lower than those of the control group,the differences were statistically significant(P<0.05).Conclusion:Although MPCNL in the treatment of impacted ureteral calculu

关 键 词：微创经皮肾镜碎石取石术 嵌顿性输尿管结石 结石清除率 并发症 炎症反应 复发率 

分 类 号：R699.4[医药卫生—泌尿科学]