输尿管镜钬激光碎石术联合赛洛多辛在泌尿系结石患者中的应用效果及对应激反应的影响研究  

Application effect of ureteroscopic holmium laser lithotripsy combined with silodosin in patients with urinary tract stones and its impact on stress response

作　　者：陈昆 韩俊岭 钱小磊 张海波[1] CHEN Kun;HAN Jun-ling;QIAN Xiao-lei;ZHANG Hai-bo(Department of Urology,the Fifth Clinical Medical College of Henan University of Chinese Medicine,Zhengzhou People's Hospital,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院,郑州人民医院泌尿外科,郑州450003

出　　处：《医药论坛杂志》2025年第1期66-69,74,共5页Journal of Medical Forum

摘　　要：目的探讨输尿管镜钬激光碎石术联合赛洛多辛在泌尿系结石患者中的应用效果及对应激反应的影响。方法选择郑州人民医院2019年1月—2024年1月收治的150例泌尿系结石患者为研究对象,信封法分为两组,各75例。对照组采用输尿管镜钬激光碎石术治疗,观察组联合赛洛多辛治疗,两组术后5 d评估患者效果,比较两组视觉模拟疼痛(visual analogue scale,VAS)评分、血清炎症因子、应激反应及不良反应发生率。结果观察组干预后VAS评分、白介素-6(interleukin-6,IL-6)、肿瘤坏死因子(tumor necrosis factor,TNF-α)及超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)低于对照组,差异有统计学意义(P<0.05)。两组干预5 d后均伴有不同程度应激反应,表现为皮质醇(cortisol,Cor)、醛固酮(aldosterone,ALD)及去甲肾上腺素(norepinephrine,NE)水平升高;观察组Cor、ALD及NE水平低于对照组,差异有统计学意义(P<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论输尿管镜钬激光碎石术联合赛洛多辛能减轻泌尿系结石患者疼痛,有助于降低血清炎症因子水平,应激反应较轻,未增加不良反应发生率,值得推广应用。Objective To explore the application effect of ureteroscopic holmium laser lithotripsy combined with silodosin in patients with urinary tract stones and its impact on stress response.Methods Totally 150 patients with urinary tract stones admitted to Zhengzhou People's Hospital from January 2019 to January 2024 were selected as the subjects,and were divided into two groups using envelope method,with 75 cases in each group.The control group received ureteroscopic holmium laser lithotripsy treatment,while the observation group received combined treatment with silodosin.The patient efficacy was evaluated 5 days after surgery in both groups,and the visual analogue scale(VAS)score,serum inflammatory factors,stress response,and incidence of adverse reactions were compared between the two groups.Results VAS score,interleukin-6(IL-6),tumor necrosis factor(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)in observation group were lower than those in control group after intervention(P<0.05).After 5 days of intervention,both groups were accompanied by varying degrees of stress response,manifested as elevated levels of cortisol(Cor),aldosterone(ALD),and norepinephrine(NE);the levels of Cor,ALD,and NE in the observation group were lower than those in the control group(P<0.05);there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ureteroscopic holmium laser lithotripsy combined with silodosin can alleviate pain in patients with urinary tract stones,help reduce serum inflammatory factor levels,alleviate stress reactions,and do not increase the incidence of adverse reactions.It is worth promoting and applying.

关 键 词：输尿管镜钬激光碎石术 赛洛多辛 泌尿系结石 应激反应 血清炎症因子 

分 类 号：R699.4[医药卫生—泌尿科学]