双镜联合一期手术应用于肾及肾盂输尿管连接部多发结石合并脓肾治疗中的有效性及复发率探讨  

Exploration of the effectiveness and recurrence rate of double-lens combination combined with one-stage surgery in the treatment of multiple stones in the kidney and ureteropelvic junction combined with pyonephrosis

作　　者：黄志雄 连乐林 张育周 HUANG Zhi-xiong;LIAN Le-lin;ZHANG Yu-zhou(Puning Overseas Chinese Hospital,Guangdong 515300,China)

机构地区：[1]普宁华侨医院,515300

出　　处：《中国现代药物应用》2024年第21期16-19,共4页Chinese Journal of Modern Drug Application

摘　　要：目的探究双镜联合一期手术应用于肾及肾盂输尿管连接部多发结石合并脓肾治疗中的有效性及复发率。方法60例肾及肾盂输尿管连接部多发结石合并脓肾患者,通过随机数字表法分为对照组和观察组,每组30例。对照组患者实施输尿管软镜碎石术,观察组实施双镜联合(肾镜及输尿管软镜)一期手术。比较两组结石清除率、术后结石复发率、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)]水平。结果术后1 d、7 d、1个月,观察组患者的结石清除率分别为93.33%、96.67%、96.67%,均高于对照组的73.33%、76.67%、80.00%(P<0.05)。术后3、6个月,观察组患者的结石复发率分别为0、3.33%,均低于对照组的13.33%、20.00%(P<0.05)。术后1、7 d,观察组患者的TNF-α、IL-6、CRP、PCT水平均低于对照组(P<0.05)。结论肾及肾盂输尿管连接部多发结石合并脓肾患者采用双镜联合一期手术治疗,可提高结石清除率,降低术后结石复发率及炎症因子水平,值得临床推广。Objective To explore the effectiveness and recurrence rate of double-lens combination combined with one-stage surgery in the treatment of multiple stones in the kidney and ureteropelvic junction combined with pyonephrosis.Methods 60 patients with multiple stones in the kidney and ureteropelvic junction combined with pyonephrosis were divided into a control group and an observation group according to random numerical table,each consisting of 30 cases.Patients in the control group underwent flexible ureteral lithotripsy,and the observation group performed double-lens combination(renoscopy and flexible ureteroscopy).Comparison was made on the stone clearance rate,postoperative stone recurrence rate,and the level of inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)]between the two groups.Results The stone clearance rates of the observation group were 93.33%,96.67%and 96.67%at 1 d,7 d and 1 month postoperatively,which were higher than 73.33%,76.67%and 80.00%of the control group(P<0.05).The stone recurrence rates of the observation group were 0 and 3.33%at 3 and 6 months postoperatively,which were lower than 13.33%and 20.00%of the control group(P<0.05).The levels of TNF-α,IL-6,CRP and PCT in the observation group at 1 and 7 d postoperatively were lower than those in the control group(P<0.05).Conclusion For patients with multiple stones in the kidney and ureteropelvic junction combined with pyonephrosis,double-lens combination combined with one-stage surgery can improve the stone clearance rate,reduce the postoperative stone recurrence rate and the level of inflammatory factors,which is worthy of clinical promotion.

关 键 词：肾及肾盂输尿管连接部多发结石 脓肾 双镜联合一期手术 输尿管软镜碎石术 结石清除率 结石复发率 炎症因子 

分 类 号：R699.2[医药卫生—泌尿科学]