取石网篮辅助输尿管软镜在肾下盏嵌顿结石中的应用效果  

Application of stone basket assisted ureteroscopy in the treatment of incarcerated stones in the lower renal calyx

作　　者：刘存兵 Liu Cunbing(Department of Urology,Fuyong People's Hospital in Bao'an District,Shenzhen,Guangdong 518103,China)

机构地区：[1]深圳市宝安区福永人民医院泌尿外科,广东深圳518103

出　　处：《泌尿外科杂志（电子版）》2024年第3期21-24,共4页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的探讨取石网篮辅助输尿管软镜对肾下盏嵌顿结石的应用效果。方法选取2023年1—12月深圳市宝安区福永人民医院收治的63例肾下盏结石患者作为研究对象,按照随机数字表法分为研究组(n=31)与对照组(n=32)。对照组采用输尿管软镜下钬激光碎石术,研究组在对照组基础上采用取石网篮辅助治疗。比较两组手术情况、手术前后肾功能指标、应激反应指标、并发症发生率。结果研究组术中出血量低于对照组,住院时间短于对照组,结石清除率高于对照组,差异有统计学意义(P<0.05)。术后3 d,研究组血肌酐(serum creatinine,Scr)、同型半胱氨酸(homocysteine,HCY)较对照组低,胱抑素C(cystatin C,CysC)较对照组高,差异有统计学意义(P<0.05)。术后3 d,研究组血清去甲肾上腺素(norepinephrine,NE)、皮质醇(cortisol,Cor)、促肾上腺皮质激素(adrenocorticotropic hormone,ACTH)较对照组低,差异有统计学意义(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论取石网篮辅助输尿管软镜能够提高肾下盏嵌顿结石患者的手术治疗效果,可改善术后肾功能,缓解手术应激状态,且具有较好的安全性。Objective To analyze the application effect of stone basket assisted ureteroscopy in the treatment of incarcerated stones in the lower renal calyx.Methods A total of 63 patients with renal calyceal stones admitted to our hospital from January to December 2023 were selected and randomly assigned to a combination group(n=31)and a control group(n=32)using a random number table.The control group received holmium laser lithotripsy under ureteroscopy,while the combination group received adjuvant treatment with a stone retrieval basket in addition to the control group.Results The intraoperative blood loss in the combined group was lower than that in the control group,the hospital stay was shorter than that in the control group,and the clear rate of stones was higher than that in the control group(P<0.05).The serum levels of cystatin C(CysC)were lower in the two groups after surgery,while the levels of serum creatinine(Scr)and cysteine(HCY)were higher than those before operation,and the serum CysC levels in the combined group were relatively higher,while the serum levels of Scr and HCY were relatively lower(P<0.05).The levels of serum norepinephrine(NE),cortisol(Cor),and adrenocorticotropic hormone(ACTH)in both groups increased compared to before treatment,however the combined group was relatively lower(P<0.05).There was no statistically significant difference in the total postoperative complication rate between the two groups(P>0.05).Conclusion The use of stone basket assisted ureteroscopy is beneficial for improving the surgical treatment effect of patients with incarcerated stones in the renal pelvis,improving postoperative renal function and stress status,and it has high safety.

关 键 词：肾下盏嵌顿结石 输尿管软镜 取石网篮 

分 类 号：R692.4[医药卫生—泌尿科学]