输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效及对并发症的影响  

Clinical Efficacy of Flexible Ureteroscope and Percutaneous Nephrolithotripsy in the Treatment of Larger Renal and Ureteral Calculi and its Influence on Complications

作　　者：郑继仁 ZHENG Jiren(Urology Department of Yanshan County People's Hospital,Yanshan 334500,Jiangxi,China)

机构地区：[1]铅山县人民医院泌尿外科,江西铅山334500

出　　处：《医学信息》2025年第1期101-104,136,共5页Journal of Medical Information

摘　　要：目的比较输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效及对并发症的影响。方法选取2020年6月-2023年6月铅山县人民医院收治的较大肾输尿管结石患者60例为研究对象,根据随机数字表法将其分成对照组和观察组,每组30例,对照组行经皮肾镜碎石术,观察组行输尿管软镜碎石术。比较两组手术指标(手术时间、术中出血量、留置导尿管时间、住院时间)、应激反应指标[中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、超氧化物歧化酶(SOD)、丙二醛(MDA)]、炎症反应[白细胞介素-10(IL-10)、C反应蛋白(CRP)和白细胞计数(WBC)]和并发症(输尿管水肿、血尿、肾包膜下血肿)发生率。结果观察组手术时间长于对照组,术中出血量、留置导尿管时间、住院时间短于对照组(P<0.05)。术后24 h,观察组nGAL、MDA水平低于对照组,SOD水平高于对照组(P<0.05)。观察组IL-10、CRP及WBC水平均低于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效都较好,但输尿管软镜碎石术对患者手术创伤更小,术后应激反应程度以及并发症发生率低,不会给患者带来较强的损伤或炎症反应。Objective To compare the clinical efficacy and complications of flexible ureteroscopy and percutaneous nephrolithotomy in the treatment of large renal and ureteral calculi.Methods A total of 60 patients with large renal and ureteral calculi admitted to Yanshan County People′s Hospital from June 2020 to June 2023 were selected as the research objects.According to the random number table method,they were divided into control group and observation group,with 30 patients in each group.The control group underwent percutaneous nephrolithotripsy,and the observation group underwent flexible ureteroscopic lithotripsy.The operation indexes(operation time,intraoperative blood loss,indwelling catheter time,hospitalization time),stress response indexes[neutrophil gelatinase-associated lipocalin(NGAL),superoxide dismutase(SOD),malondialdehyde(MDA)],inflammatory response[interleukin-10(IL-10),C-reactive protein(CRP)and white blood cell count(WBC)]and the incidence of complications(ureteral edema,hematuria,renal subcapsular hematoma)were compared between the two groups.Results The operation time of the observation group was longer than that of the control group,and the intraoperative blood loss,indwelling catheter time and hospitalization time were shorter than those of the control group(P<0.05).At 24 h after operation,the levels of nGAL and MDA in the observation group were lower than those in the control group,and the level of SoD was higher than that in the control group(P<0.05).The levels of IL-10,CRP and WBC in the observation group were lower than those in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion The clinical efficacy of flexible ureteroscopy and percutaneous nephrolithotomy in the treatment of large renal and ureteral calculi is better,but flexible ureteroscopy lithotripsy has less surgical trauma,lower postoperative stress response and lower incidence of complications,and will not bring strong damage or inflammatory res

关 键 词：输尿管软镜碎石术 经皮肾镜碎石术 肾结石 应激反应 炎症反应 

分 类 号：R692.4[医药卫生—泌尿科学]