F6.0/7.5输尿管镜行钬激光碎石术对男性输尿管下段结石患者应激反应、精子质量的影响  

Effects of Holmium Laser Lithotripsy with F6.0/7.5 Ureteroscopy on Stress Response and Sperm Quality in Male Patients with Lower Ureteral Calculi

作　　者：许晖阳 陈波特 邱晓拂 XU Huiyang;CHEN Bote;QIU Xiaofu(Department of Urology,The Affiliated Guangdong Second Provincial General Hospital of Jinan University,Guangzhou,Guangdong 510317,China)

机构地区：[1]暨南大学附属广东省第二人民医院泌尿外科,广东广州510317

出　　处：《转化医学杂志》2024年第11期1856-1861,共6页Translational Medicine Journal

基　　金：广东省医学科学技术研究(A2022191)。

摘　　要：目的探讨F6.0/7.5输尿管镜行钬激光碎石术对男性输尿管下段结石患者应激反应、精子质量的影响。方法选取2021年2月至2024年2月暨南大学附属广东省第二人民医院泌尿外科93例男性输尿管下段结石患者为研究对象,按照随机数字表法将其分为观察组(n=47)和对照组(n=46)。在行钬激光碎石术中,观察组采用F6.0/7.5输尿管镜,对照组采用F8.0/9.8输尿管镜,其余操作均相同,比较2组手术相关指标、清石效果、肾功能、炎症反应指标、氧化应激指标、精子质量、并发症发生率。结果观察组进镜时间、手术时间、住院时间均短于对照组(P均<0.05),术后1 d疼痛评分低于对照组(P<0.05),1次碎石成功率高于对照组(P<0.05);观察组结石清除率稍高,但2组间比较差异无统计学意义(P>0.05);观察组术后7 d尿素氮(BUN)、血肌酐(Scr)、胱抑素C(CysC)及C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)、皮质醇(Cor)、去甲肾上腺素(NE)、丙二醛(MDA)水平均低于对照组(P均<0.05);术后7 d,2组精子密度、精子活率均下降,精子畸形率均升高,但观察组精子密度、精子活率均高于对照组,而精子畸形率较对照组更低(P均<0.05);观察组并发症的发生率与对照组比较差异无统计学意义(4.26%vs 10.86%,P>0.05)。结论对于男性输尿管下段结石,F6.0/7.5输尿管镜行钬激光碎石术具有较好的清石效果,且可减少肾功能损伤、炎症反应、应激反应及对精子质量的影响,不增加并发症的发生风险,值得在临床推广应用。Objective To analyze the effects of holmium laser lithotripsy with F6.0/7.5 ureteroscopy on stress response and sperm quality in male patients with lower ureteral calculi.Methods A total of 93 male patients with lower ureteral calculi admitted to the Department of Urology,The Affiliated Guangdong Second Provincial General Hospital of Jinan University from February 2021 to February 2024 were selected and divided into the study group(n=47,F6.0/7.5 ureteroscopy)and the control group(n=46,F8.0/9.8 ureteroscopy)by the random number table method during holmium laser lithotripsy.The surgical indexes,stone-clearing effect,renal function[blood urea nitrogen(BUN),serum creatinine(Scr),cystatin C(CysC)],inflammatory response indexes[C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)],oxidative stress indexes[cortisol(Cor),norepinephrine(NE),malondialdehyde(MDA)],sperm quality,and complication rate were compared between the two groups.Results The ureteroscope insertion time,operation time,and hospital stay in the study group were shorter than those in the control group(P<0.05),the pain score 1 day after surgery was lower(P<0.05),the success rate of one-time lithotripsy was higher(P<0.05),and the stone clearance rate was slightly higher,without a statistically significant difference(P>0.05).BUN,Scr,CysC,CRP,IL-6,TNF-α,Cor,NE,and MDA levels in the study group were lower than those in the control group 7 days after surgery(P<0.05).On the 7th day after surgery,the sperm density and sperm motility of both groups decreased,and the sperm malformation rate increased,but the sperm density and sperm motility rate in the study group were higher,and the sperm malformation rate was lower(P<0.05).The incidence of complications between the two groups was 4.26%and 10.86%,respectively,without a statistically significant difference(P>0.05).Conclusion Holmium laser lithotripsy using F6.0/7.5 ureteroscopy for male patients with lower ureteral calculi has a good stone removal effect and can reduce renal injury,inflamma

关 键 词：F6.0/7.5输尿管镜 钬激光碎石术 男性 输尿管下段结石 应激反应 精子质量 

分 类 号：R693.4[医药卫生—泌尿科学]