三金汤联合输尿管软镜碎石取石术治疗输尿管上段嵌顿性结石的疗效以及对血清CRP、LPS和PCT的影响  

Curative effect of Sanjin Decoction combined with flexible ureteroscopic lithotripsy and its influences on serum CRP,LPS and PCT in impacted proximal urethral calculi

作　　者：李明谦 魏军利 梁鹏 郝艳君 张赛 LI Mingqian;WEI Junli;LIANG Peng;HAO Yanjun;ZHANG Sai(Department of General Surgery,Cixian County People's Hospital,Handan,Hebei,China,056500)

机构地区：[1]磁县人民医院普外科,河北邯郸056500

出　　处：《分子诊断与治疗杂志》2024年第6期1036-1039,共4页Journal of Molecular Diagnostics and Therapy

基　　金：河北省中医药管理局科研计划项目(3602012)。

摘　　要：目的 探讨三金汤联合输尿管软镜碎石取石术(FURL)在输尿管上段嵌顿性结石中的应用效果以及对血清C-反应蛋白(CRP)、内毒素(LPS)和血清降钙素原(PCT)的影响。方法 选取2020年10月至2022年7月磁县人民医院收治的80例输尿管上段嵌顿性结石患者,随机将患者分为两组,FURL组(n=40)行单纯FURL治疗,联合组(n=40)行FURL联合三金汤治疗。记录两组的治疗疗效、清石效果、炎症指标(CRP、LPS和PCT)和术后并发症并进行比较。结果 术后2周,联合组患者临床疗效为92.86%,高于FURL组的71.42%,差异有统计学意义(P<0.05)。联合组患者的术后3 d、术后1个月和术后3个月的清石率均高于FURL组,差异有统计学意义(P<0.05)。术后,两组的炎症水平均较术前升高,但联合组均低于FURL组,差异有统计学意义(P<0.05)。联合组的术后出血、输尿管穿孔和结石上移并发症发生率为10.00%,低于FURL组的27.50%,差异有统计学意义(P<0.05)。结论 三金汤联合FURL治疗输尿管上段嵌顿性结石具有较好疗效,术后结石清除率较高,可以较好地改善机体的炎症状态,减少术后并发症的发生。Objective To explore the application effect of Sanjin Decoction combined with flex-ible ureteroscopic lithotripsy(FURL)in impacted proximal urethral calculi and its influences on serum C-reac-tive protein(CRP),endotoxin(LPS)and procalcitonin(PCT).Methods A total of 80 patients with impacted proximal urethral calculi who were admitted to Cixian County Peoples Hospital from October 2020 to July 2022 were enrolled.They were randomly divided into two groups:the FURL group(n=40,FURL)and the combina-tion group(n=40,FURL combined with Sanjin Decoction).The curative effect,stone clearance effect,inflam-matory indexes[C-reactive protein(CRP),lipopolysaccharide(LPS),procalcitonin(PCT)]and postopera-tive complications in the two groups were recorded and compared.Results At 2 weeks after surgery,the clini-cal curative effect in the combination group was better than that in the FURL group,with a statistically signifi-cant difference(92.86%vs 71.42%,P<0.05).Stone clearance rates at 3 days,1 month,and 3 months after sur-gery were higher in the combination group compared to the FURL group,and the difference was statistically sig-nificant(P<0.05).Following surgery,the inflammatory factor level in both groups increased,but it was lower in the combination group than in the FURL group(P<0.05).The incidence of complications(postoperative bleeding,ureteral perforation,calculi migration)in the combination group was lower than in the FURL group,with a statistically significant difference(10.00%vs 27.50%,P<0.05).Conclusion The curative effect of San-jin Decoction combined with FURL is good for impacted proximal urethral calculi,with high postoperative stone clearance rate.This combined therapy can improve the inflammatory state and reduce the occurrence of postoperative complications.

关 键 词：输尿管上段嵌顿性结石 三金汤 输尿管软镜碎石取石术 

分 类 号：R699[医药卫生—泌尿科学]