超声引导下经皮肾镜取石术治疗肾结石的效果及对炎性创伤反应的影响  

Effect of Ultrasound-guided Percutaneous Nephrolithotomy in Treating Renal Calculi and its Influence on Inflammatory Trauma Response

作　　者：刘东东 李淑 李贝 闫书 宋军锋 刘柯柯 Liu Dongdong;Li Shu;Li Bei(Urology Department,989th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China,Luoyang,Henan,471000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八九医院泌尿外科,河南洛阳471000 [2]河南省禹州市人民医院泌尿外科,河南禹州461674

出　　处：《黑龙江医学》2025年第8期920-922,共3页Heilongjiang Medical Journal

基　　金：2020年度河南省医学科技攻关计划联合共建项目(LHGJ20200990)。

摘　　要：目的:探究超声引导下经皮肾镜取石术(PCNL)治疗肾结石的效果及对炎性创伤反应的影响。方法:选取2018年6月—2023年6月样本医院收治的96例肾结石患者作为研究对象。所有患者均接受PCNL治疗,按照入院顺序进行编号并根据随机数表法分为研究组和对照组,每组各48例。对照组接受标准通道PCNL,研究组接受超声引导下微通道PCNL。比较两组围术期指标、一次性结石清除率、二次手术率、肾功能[血肌酐(Scr)、尿素氮(BUN)]、炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、单核细胞趋化蛋白-1(MCP-1)]水平、并发症。结果:研究组术中出血量明显少于对照组,住院时间明显短于对照组,手术时间明显长于对照组,差异均有统计学意义(t=11.245、11.754、7.540,P<0.05);两组患者一次性结石清除率比较,差异无统计学意义(χ^(2)=2.700,P>0.05);术后,两组患者IL-6、MCP-1水平明显高于术前;两组患者并发症发生率比较,差异无统计学意义(χ^(2)=0.381,P>0.05)。结论:超声引导下微通道PCNL治疗肾结石能够减少术中出血量,缩短住院时间,抑制炎性创伤反应,而标准通道PCNL手术时间更短,对肾功能的影响更小。Objective:To explore the effect of ultrasound-guided percutaneous nephrolithotomy(PCNL)in the treatment of renal calculi and its influence on inflammatory trauma response.Methods:96 patients with renal calculi in the hospital from June 2018 to June 2023 were selected as the observation subjects.All patients received PCNL treatment and were numbered according to the order of admission.They were divided into study group(48 cases)and control group(48 cases)by adopting the random number table method.The control group received standard channel PCNL,while the study group was given ultrasound-guided microchannel PCNL.The perioperative indicators,one-time stone clearance rate,secondary surgery rate,renal function[serum creatinine(Scr),blood urea nitrogen(BUN)],inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),monocyte chemoattractant protein-1(MCP-1)]and complications were compared between groups.Results:The intraoperative blood loss of the study group was significantly less than that of the control group,the hospitalization time was significantly shorter than that of the control group,and the operation time was significantly longer than that of the control group,with statistically significant difference(t=11.245,7.540,11.754;P<0.05).There was no significant difference in one-time stone clearance between the two groups(χ^(2)=2.700,P>0.05).After operation,the levels of IL-6,TNF-α,MCP-1,IL-6,TNF-αand MCP-1 in 2 groups were significantly higher than those before operation.There was no significant difference in the incidence of complications between two groups(χ^(2)=0.381,P>0.05).Conclusion:Ultrasound-guided microchannel PCNL in the treatment of renal calculi can reduce the intraoperative blood loss,shorten the hospital stay and inhibit the inflammatory trauma response,but standard channel PCNL has shorter surgical time and smaller impact on renal function.

关 键 词：肾结石 经皮肾镜取石 超声 炎性创伤反应 

分 类 号：R699.2[医药卫生—泌尿科学]