经皮肾镜碎石术治疗复杂性肾结石患者的预后效果影响  

Prognostic Effect of Percutaneous Nephrolithotomy in Patients with Complicated Kidney Stones

作　　者：周广春 张永贺 Zhou Guangchun;Zhang Yonghe(Department of Urology,Chengwu CountyI People's Hospital of Shandong Province,Heze 274200,Shandong Province,China;不详)

机构地区：[1]山东省成武县人民医院泌尿外科,山东省菏泽市274200

出　　处：《中国病案》2025年第2期105-109,共5页Chinese Medical Record

摘　　要：目的 研究经皮肾镜碎石术治疗复杂性肾结石患者的预后效果及对术后早期尿素氮(BUN),血肌酐(Scr),白细胞介素-6(IL-6),IL-8及超敏C反应蛋白(hs-CRP)水平的影响。方法 选择从2022年2月1日到2024年1月1日在某院接受手术治疗的复杂性肾结石患者156例。按手术方法的不同划分观察组与对照组各78例,为对照组给予开放性术式进行治疗,为观察组给予经皮肾镜碎石术进行治疗。对比两组结石清除率及复发率,预后相关指标,术前及术后7天的BUN,Scr,IL-6,IL-8及hs-CRP水平,以及术后并发症。结果 观察组的结石清除率是96.30%,较对照组的87.18%明显更高,而复发率为2.56%,较对照组的11.54%明显更低(P<0.05)。观察组手术、肛门排气、下床活动和住院等时间均分别较对照组更短,而术中出血量较对照组更少(P<0.05)。术后两组BUN和Scr较术前降低,观察组更低(P<0.05)。术后两组IL-6,IL-8及hs-CRP较术前升高,且观察组更低(P<0.05)。观察组术后并发症的总发生率是5.13%,较对照组的17.95%明显更低(P<0.05)。结论 经皮肾镜碎石术治疗复杂性肾结石患者的预后效果较好,同时还能改善患者的术后早期肾功能及炎症状态水平,安全性较高,值得推广。Objective To study the prognostic effect of percutaneous nephrolithotomy on the levels of BUN,Scr,IL-6,IL-8 and hs-CRP in the early postoperative period.Methods A total of 156 patients with complicated kidney stones treated by surgery in our hospital from February 1st,2022 to January 1st,2024 were selected.According to the difference of surgical method,divided into the observation group and the control group with 78 cases in each.Control group was given open surgical treatment,and percutaneous nephrolithotripsy was given for the observation group.The two groups were compared with the stone clearance rate and recurrence rate,prognosis-related indicators,BUN,Scr,IL-6,IL-8 and hs-CRP levels before and 7d after surgery,and postoperative complications.Results The stone clearance rate in observation group was 96.30%,higher than 87.18%in control group,while the recurrence rate was 2.56%,lower than 11.54%in control group(P<0.05).The operation time and anal exhaust time,ambulation time,and hospitalization time were shorter in the observation group than control group,and intraoperative bleeding of observation group were less in the control group(P<0.05).The BUN and Scr levels in the two groups were lower than preoperative group,and observation group was lower than control group(P<0.05).The postoperative levels of IL-6,IL-8 and hs-CRP were significantly higher than the preoperative levels,observation group was lower than control group(P<0.05).The overall incidence of postoperative complications in the observation group was 5.13%,lower than 17.95%in control group(P<0.05).Conclusions Percutaneous nephrolithotripsy could treat patients with complicated renal stones well,and could also improve the early postoperative renal function and inflammatory status,with high safety,which was worth popularizing.

关 键 词：经皮肾镜碎石术 复杂性肾结石 预后效果 术后早期 BUN Scr IL-6 IL-8 hs-CRP 

分 类 号：R699.2[医药卫生—泌尿科学]