摘要
目的分析微创钬激光碎石术对复杂性肾结石的手术效果及对氧化应激指标的影响。方法研究对象选取2019年1—12月于我院诊治的复杂性肾结石患者60例,根据手术方式的不同将其分为两组,接受经皮肾镜取石术者为对照组(n=30),而同期采用联合微创钬激光碎石术者为观察组(n=30)。比较两组患者手术相关指标以及手术前后氧化应激情况,同时比较术后结石清除率和并发症发生率。结果观察组患者的手术时间、术中出血量及住院时间均优于对照组,差异有统计学意义(P<0.05);治疗后,观察组患者的谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、超氧化物歧化酶(superoxide dismutase,SOD)均高于对照组,而血清丙二醛(malonic dialdehyde,MDA)明显低于对照组(P<0.05);观察组患者结石清除率为96.67%,明显高于对照组的70.00%(χ^(2)=7.68,P=0.01);观察组患者的发热、漏尿及切口感染并发症的总发生率为6.67%,明显低于对照组的26.67%(χ^(2)=4.32,P=0.03)。观察组C反应蛋白(C-reactive protein,CRP)和白细胞介素-6(interleukin-6,IL-6)指标均显著低于对照组(P<0.05)。结论复杂性肾结石患者采用经皮肾镜取石术联合微创钬激光碎石术治疗效果显著,可改善手术各项指标情况,优化术后氧化应激情况,提高结石清除率,同时减少术后并发症,增强手术安全性,值得临床借鉴。
Objective To analyze the effect of minimally invasive holmium laser lithotripsy on complicated kidney stones and the influence of oxidative stress indicators.Methods A total of 60 patients with complicated kidney stones who were diagnosed and treated in our hospital from January to December 2019 were selected as the study subjects.Patients were divided into control group(percutaneous nephrolithotomy,n=30)and observation group(combined with minimally invasive holmium laser lithotriptomy,n=30)according to surgical methods.The operation-related indicators and the oxidative stress of patients before and after the operation were compared between the two groups,and the postoperative stone clearance rate and complication rate were compared.Results The operative time,intraoperative blood loss,length of hospital stay in observation group were better than those in control group,and the difference was statistically significant(P<0.05).After treatment,the observation group's glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)were significantly higher than those of the control group,while malonic dialdehyde(MDA)was significantly lower than that of the control group(P<0.05);the stone clearance rate of the observation group was 96.67%,which was significantly higher than that of the control group(70.00%)(χ^(2)=7.68,P=0.01);the total incidence of complications of fever,urine leakage and incision infection in the observation group was 6.67%,which was significantly lower than that in the control group(26.67%)(χ^(2)=4.32,P=0.03).The indexes of C-reactive protein(CRP)and interleukin-6(IL-6)in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Percutaneous nephrolithotomy combined with minimally invasive holmium laser lithotripsy has a significant therapeutic effect on patients with complex kidney stones,which can improve various surgical indicators,optimize postoperative oxidative stress,increase stone clearance rate,and reduce surgery complications,enhance the safety of surgery,is worthy of clinical reference.
作者
杨俊
李淦洪
姜华
曾嘉庆
杨显红
YANG Jun;LI Ganhong;JIANG Hua;ZENG Jiaqing;YANG Xianhong(Urinary Surgery,Fifth Affiliated Hospital of Zunyi Medical University(Zhuhai),Zhuhai Guangdong 519100,China)
出处
《中国卫生标准管理》
2022年第10期87-90,共4页
China Health Standard Management
关键词
微创钬激光碎石术
复杂性肾结石
氧化应激指标
结石清除率
并发症
经皮肾镜取石术
minimally invasive holmium laser lithotripsy
complicated kidney stones
oxidative stress indicators
stone clearance rate
complications
percutaneous nephrolithotomy
