超声引导微通道经皮肾镜气压弹道碎石术对复杂性输尿管上段结石患者血清应激激素水平及炎性因子的影响
牛嘉威1① ,史沁兵1 ,刘 畅2
(1.鹤壁市人民医院泌尿外科,河南 鹤壁 458030;2.鹤壁市中医院泌尿外科,河南 鹤壁 458030)
摘要 目的:分析超声引导微通道经皮肾镜气压弹道碎石术对复杂性输尿管上段结石患者血清应激激素水平及炎性因子的影响。 方法:选取 103 例复杂性输尿管上段结石患者作为研究对象,按照随机数字表法分为观察组 52 例和对照组 51 例。对照组给予输尿管镜碎石术治疗,观察组给予超声引导微通道经皮肾镜气压弹道碎石术治疗,对比两组患者手术效果、应激激素水平和炎性因子水平。结果:观察组术后 1 个月结石清除率高于对照组,手术时间、术中出血量、术后住院时间均优于对照组(P<0.05);观察组促肾上腺皮质激素(ACTH)、皮质醇(COR)、去甲肾上腺素(NE)水平均低于对照组(P<0.05);观察组白细胞(WBC)计数、C 反应蛋白(CRP)、白细胞介素-10(IL-10)水平均低于对照组(P<0.05)。 结论:复杂性输尿管上段结石患者应用超声引导微通道经皮肾镜气压弹道碎石术效果确切,能够改善术后应激反应及炎症反应。
关键词: 微通道经皮肾镜气压弹道碎石术;复杂性输尿管上段结石;应激激素;炎性因子
中图分类号:R699.4 文献标志码:A 文章编号:1008-2409(2022)03-0005-05
Effects of ultrasound-guided percutaneous nephrolithotomy combined with microchannel pneumatic lithotripsy on serum stress hormone levels and inflammatory factors in patients with complicated upper ureteral calculi
NIU Jiawei 1① ,SHI Qinbing 1 ,LIU Chang 2 . (1. Dept. of Urology, Hebi People’s Hospital, Hebi 458030; 2. Dept. of Urology, Hebi Hospital of Traditional Chinese Medicine, Hebi 458030, China)
Abstract Objective: To analyze the effects of ultrasound-guided percutaneous nephrolithotomy on serum stress hormone levels and inflammatory factors in patients with complicated upper ureteral calculi. Methods: A total of 103 patients with complicated upper ureteral calculi were randomized into the observation group and control group. 51 patients in the control group were treated with ureteroscope lithotripsy, while another 52 patients in the observation group were treated with ultrasound-guided percutaneous nephrolithotomy under pneumatic pressure. Then, the surgical effects, stress hormone level and inflammatory factors were compared between the two groups. Results: The calculus clearance rate 1 month after operation in the observation group was higher than that in control group, while the operation time, surgical blood loss and postoperative hospital stays were superior to those in control group(P<0.05); levels of ACTH, COR and NE in the observation group were lower than those in control group(P<0.05); WBC count, C-reactive protein(CRP) and interleukin-10(IL-10) levels in the observation group were lower than those in control group(P<0.05). Conclusion: Ultrasound-guided percutaneous nephrolithotomy with microchannel pneumatic lithotripsy is effective for patients with complicated upper ureteral calculi, which can improve postoperative stress response and inflammatory response.
Keywords: microchannel percutaneous nephrolithotomy with microchannel pneumatic lithotripsy; complex upper ureteral calculi; stress hormone; inflammatory factor
参考文献:
[1] LI M J,ZHANG H,JIANG D Q,et al.Calculus-related func-tional protein expression in ureteral calculus-adhered polyp:a preliminary study[J].Medicine,2021,100(25):1-7.
[2] 包果,李虎林.微创碎石术治疗复杂性输尿管上段结石对患者应激激素和免疫功能的影响[J].中国性科学,2020,29(9):10-13.
[3] 卢亚红,董娇娇,郭利红.斜卧位经超声引导微通道经皮肾镜碎石取石术治疗泌尿系结石效果分析及护理干预[J].贵州医药,2021,45(6):922-923.
[4] 陈兴发.泌尿系结石诊疗指南解读[J].现代泌尿外科杂志,2010,15(6):408-410.
[5] LIU N N,ZHANG Y,SHAN K,et al.Sonographic twinkling artifact for diagnosis of acute ureteral calculus[J]. World Journal of Urology,2020,38(2):489-495.
[6] 龚宾宾,郝宗耀,梁朝朝.输尿管结石术后输尿管狭窄的影响因素研究进展[J]. 微创泌尿外科杂志,2021,10(1):65-69.
[7] HUYNH E,BASCUNAN A L,CASE J B,et al.Use of radiography,ultrasonography,and computed tomography in the diagnosis of a pyogranulomatous ureteral mass in a cat[J].Veterinary Radiology & Ultrasound,2020,61(6):E55-E59.
[8] 朱斌,潘卫兵,罗林斌,等.超声引导经皮肾镜取石术治疗复杂性肾结石的疗效分析[J].临床超声医学杂志,2018,20(7):493-495.
[9] 秦刚,谢英金.输尿管软镜下钬激光碎石术对复杂性上尿路结石患者疗效及术后复发的影响[J].实用医院临床杂志,2021,18(5):166-169.
[10] 谷炎,万水,刘国政,等.超声引导经皮肾镜取石术不逆行输尿管插管可行性与效果观察[J].临床外科杂志,2021,29(6):570-572.
[11] 庞国福,朱雨沫,叶啸.输尿管软镜与经皮肾镜在肾结石患者中的应用及对肾功能凝血功能及氧化应激产物的影响[J].血栓与止血学,2021,27(5):849-850.
[12] 梁苏东,吕高飞,阮亚石,等.输尿管软镜碎石术与经皮肾镜碎石术对肾结石患者炎性因子、氧化应激及应激激素水平的影响[J].海南医学院学报,2017,23(20):2783-2786.
[13] 李铁,薛超,及东林,等.经皮肾镜碎石术和输尿管软镜碎石术治疗肾结石的临床疗效比较和对机体氧化应激状态的影响[J].国际泌尿系统杂志,2017,37(3):361-364.
[14] 康启源,张辉,毕航,等.输尿管镜下钬激光与气压弹道碎石术对老年输尿管上段结石患者应激反应及碎石效果的比较[J].中华老年多器官疾病杂志,2019,18(2):127-131.
[15] 王文涛,简百录,乔少谊,等.坦洛新对输尿管下段结石患者体外冲击波碎石术后排石及血清 IL-6,IL-10 和CRP 水平的影响[J].现代生物医学进展,2018,18(21):4099-4102.
[16] 朱通,刘旭东,何俊,等.输尿管镜下钬激光碎石治疗对复杂性输尿管结石合并肾盂积水患者炎症指标的影响[J].微创泌尿外科杂志,2020,9(2):96-100.
PDF下载：点击下载
版权所有：华夏医学(Acta Medicinae Sinica) 联系电话：0773-2805467 电子邮箱：huaxia@glmc.edu.cn 地址：广西桂林市临桂区致远路1号桂林医学院明德楼316 (541199)