输尿管软镜碎石术与经皮肾镜治疗输尿管上段结石对术后应激及免疫功能影响的临床研究  

Clinical application of flexible ureteral lithotripsy and percutaneous nephrolithotomy on the postoperative stress and immune function of upper ureteral calculi

作　　者：张路锋 詹绍洋 Zhang Lufeng;Zhan Shaoyang(Department of Urology,Heifei BOE Hospital,Hefei 230000,China)

机构地区：[1]合肥京东方医院泌尿外科,合肥230000

出　　处：《微创泌尿外科杂志》2024年第5期313-317,共5页Journal of Minimally Invasive Urology

摘　　要：目的:探究输尿管软镜碎石术与经皮肾镜在治疗输尿管上段结石中对患者术后应激、免疫功能的影响。方法:选取2019年1月至2023年12月合肥京东方医院收治的180例输尿管上段结石患者,采用随机数字表法分为对照组80例(微通道经皮肾镜碎石术)和观察组100例(输尿管软镜碎石术),比较两组的术后应激反应指标[去甲肾上腺素(NE)、皮质醇(COR)、促肾上腺皮质激素(ACTH)]及免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))。结果:术前两组NE、COR、ACTH、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异均无统计学意义(P>0.05)。术后,对照组NE、COR、ACTH水平显著上升(P<0.05),CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)显著下降(P<0.05);观察组NE、COR、ACTH及CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比较差异均无统计学意义(P>0.05)。观察组术后NE、COR、ACTH水平均低于对照组,CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均高于对照组,差异均有统计学意义(P<0.05)。结论:输尿管软镜碎石术在治疗输尿管上段结石时,较微通道经皮肾镜碎石术对应激、免疫功能的影响轻。Objective:To explore the clinical study of the effects of flexible ureteral lithotripsy and percutaneous nephrolithotomy on postoperative stress and immune function in the treatment of upper ureteral calculi.Methods:180 patients with upper ureteral stones admitted to Heifei BOE Hospital from January 2019 to December 2023 were divid-ed into control group(80 cases,microchannel percutaneous nephrolithotripsy)and observation group(100 cases,ure-teral soft lithotripsy)by random number table method.The stress response indicators[norepinephrine(NE),cortisol(COR),adrenocorti-cotrophic hormone(ACTH)]and immune function(CD4^(+),CD8^(+),CD4^(+)/CD8^(+))were compared between the two groups.Results:Before operation,there was no statistically significant difference in NE,COR,ACTH,CD4^(+),CD8^(+)or CD4^(+)/CD8^(+)between the two groups(P<0.05).After surgery,the NE,COR and ACTH levels in the control group significantly increased(P<0.05),while the CD4^(+),CD8^(+),CD4^(+)/CD8^(+)significantly decreased(P<0.05).In the observation group after surgery,there was no statistically significant differ-ence in NE,COR,ACTH,CD4^(+),CD8^(+)or CD4^(+)/CD8^(+)(P>0.05),the NE,COR and ACTH levels were lower than that in the control group,while the CD4^(+),CD8^(+),CD4^(+)/CD8^(+)were higher than that in the control group,the differences were statistically significant(all P<0.05).Conclusion:Ureteroscopic lithotripsy has a milder effect on postoperative stress and immune function compared to micro-percutaneous nephrolithotomy in the treatment of upper ureteral stones.

关 键 词：输尿管上段结石 输尿管软镜碎石 经皮肾镜碎石 应激反应 免疫功能 

分 类 号：R699.4[医药卫生—泌尿科学]