摘要
目的探讨输尿管软镜治疗肾结石的效果及对患者尿液中肾损伤分子-1(KIM-1)、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)表达水平的影响。方法回顾性选取2015年2月至2017年11月我院收治的肾结石患者74例,根据手术方法不同分为对照组和观察组。对照组患者采用标准经皮肾镜取石术治疗,观察组患者输尿管软镜取石术治疗,分析两组患者治疗后的临床效果。结果观察组手术时间、住院时间短于对照组,血红蛋白下降量少于对照组,但两组结石清除率比较,差异无统计学意义(P>0.05)。术前,两组患者KIM-1、NGAL、Cys-C、应激因子水平比较,差异无统计学意义(P>0.05)。观察组术后2d时KIM-1水平低于对照组;术后1d、2d、3d时Cys-C水平高于对照组,术后同时间NGAL水平与对照组比较,差异无统计学意义(P>0.05);术后1d、2d、3d时SOD水平高于对照组,MDA、IL-6、CRP水平低于对照组,差异有统计学意义(P<0.05)。观察组患者并发症率为13.51%,对照组为10.81%,观察组患者并发症率与对照组比较,差异无统计学意义(P>0.05)。结论输尿管软镜取石术治疗肾结石手术时间短,创伤小,对机体应激反应较小,且并不增加并发症率,但会肾损伤小球功能,应用时需注意肾功能的保护。
Objective To investigate the effects of soft ureteroscopy and standard percutaneous nephrolithotomy on the expression of renal injury molecule-1(KIM-1)and serum neutrophil gelatinase-associated lipid carrier protein(NGALs)in urine of patients with renal calculi. Methods 74 patients with renal calculi from February 2015 to November 2017 were retrospectively selected and divided into control group and observation group according to different surgical methods.The patients in the control group were treated with standard percutaneous nephrolithotomy and the patients in the observation group were treated with soft ureteroscopy. Results The operation time and hospitalization time in the observation group were shorter than those in the control group,and the decrease of hemoglobin in the observation group was less than that in the control group,but there was no significant difference in stone clearance rate between the two groups( P >0.05).Before operation,there was no significant difference in the levels of stress factors between the two groups( P >0.05).The level of KIM-1 in the observation group was lower than that in the control group at 2 days after operation,and the level of Cys-C in the observation group was higher than that in the control group on the 1st and 2nd day after operation( P >0.05),and there was no significant difference in the level of NGAL between the observation group and the control group at the same time( P >0.05).The level of SOD was significantly higher than that of control group( P <0.05).The complication rate was 13.51 in the observation group and 10.81 in the control group.There was no significant difference between the observation group and the control group( P >0.05). Conclusion The operation time of ureteroscopic lithotripsy in the treatment of renal calculi is short,the trauma is small,the stress response to the body is small,and the complication rate does not increase,but it should be paid attention to when the kidney is damaged.
作者
罗继毅
李成山
Luo Jiyi;Li Chengshan(Baise People′s Hospital,Baise,Guangxi 533000,China)
出处
《四川医学》
CAS
2019年第6期606-610,共5页
Sichuan Medical Journal
关键词
输尿管软镜
经皮肾镜
肾结石
尿液中肾损伤分子-1
flexible ureteroscopy
percutaneous nephrolithotomy
renal calculi
renal injury molecule-1 in urine
