摘要
目的:比较用输尿管软镜钬激光碎石术与经皮肾镜钬激光碎石术治疗肾结石的效果及对患者肾功能的影响。方法:将新疆生产建设兵团医院收治的92例肾结石患者随机分为输尿管软镜组与肾镜组。分别用输尿管软镜钬激光碎石术与经皮肾镜钬激光碎石术对输尿管软镜组患者与肾镜组患者进行治疗,然后比较两组患者的各项临床指标。结果:与肾镜组患者相比,输尿管软镜组患者中结石直径≤20 mm患者结石的清除率更高,P<0.05。与输尿管软镜组患者相比,肾镜组患者中结石直径>20 mm患者结石的清除率更高,P<0.05。与肾镜组患者相比,输尿管软镜组患者术中的出血量更少,其手术的时间更长,其术后住院的时间更短,其术后血红蛋白水平下降的幅度更小,P<0.05。术后12 h,与肾镜组患者相比,输尿管软镜组患者血清NGAL和血清Cys-C的水平均更高,其尿Kim-1的水平更低,P<0.05。两组患者术后并发症的发生率相比,P>0.05。结论:用输尿管软镜钬激光碎石术与经皮肾镜钬激光碎石术治疗肾结石时对于不同直径的结石具有不同的清除效果,这两种术式均会对患者的肾功能产生一定的影响。
Objective:To compare the effect of flexible ureteroscopic holmium laser lithotripsy with percutaneous holmium laser lithotripsy in the treatment of kidney stones and its influence on renal function of patients.Methods:Ninety-two patients with kidney stones admitted to Xinjiang Production and Construction Corps hospital were randomly divided into ureteroscope group and nephroscope group.Flexible ureteroscope holmium laser lithotripsy and percutaneous holmium laser lithotripsy were used to treat the patients in the flexible ureteroscope group and the nephroscope group respectively,and then the clinical indicators of the two groups of patients were compared.Results:Compared with the nephroscope group,patients with calculi diameter≤20 mm in the ureteroscope group had a higher calculi clearance rate(P<0.05).Compared with the patients in the flexible ureteroscopy group,the nephrectomy rate was higher in patients with a stone diameter of>20 mm in the nephroscopy group(P<0.05).Compared with the nephroscope group,the patients in the flexible ureteroscope group had less intraoperative blood loss,longer operative time,shorter postoperative hospital stay,and smaller postoperative decrease in hemoglobin level(P<0.05).At 12 h after the operation,compared with the patients in the nephroscope group,the serum LEVELS of NGAL and CYS-C in the ureteroscope group were both higher,and the urinary KIM-1 level was lower,P<0.05.The incidence of postoperative complications between the two groups was P>0.05.Conclusion:Flexible ureteroscopic holmium laser lithotripsy and percutaneous holmium laser lithotripsy have different removal effects for stones of different diameters.Both of these two surgical methods have a certain impact on the renal function of patients.
作者
朱红学
马旺
汤磊
李志坤
李前跃
赵亚伟
王秀琴
Zhu Hongxue;Ma Wang;Tang Lei;Li Zhikun;Li Qianyue;Zhao Yawei;Wang Xiuqin(Department of Urology,Xinjiang Production and Construction Corps Hospital,Urumqi Xinjiang 830002)
关键词
输尿管软镜钬激光碎石术
经皮肾镜钬激光碎石术
肾结石
肾功能
flexible ureteroscope holmium laser lithotripsy
Percutaneous holmium laser lithotripsy
Kidney stones
renal function
