[1]石奇刚,孙永恒,任艳胜.微创经皮肾镜取石术治疗输尿管上段结石合并轻度肾积水疗效观察[J].新乡医学院学报,2017,34(3):235-237.[doi:10.7683/xxyxyxb.2017.03.021]
　SHI Qi-gang,SUN Yong-heng,REN Yan-sheng.Therapeutic effect of minimally invasive percutaneous nephrolithotomy in treatment of upper urinary calculi complicated with mild hydronephrosis[J].Journal of Xinxiang Medical University,2017,34(3):235-237.[doi:10.7683/xxyxyxb.2017.03.021]
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微创经皮肾镜取石术治疗输尿管上段结石合并轻度肾积水疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年3
页码:
235-237
栏目:
临床研究
出版日期:
2017-03-05

文章信息/Info

Title:
Therapeutic effect of minimally invasive percutaneous nephrolithotomy in treatment of upper urinary calculi complicated with mild hydronephrosis
作者:
石奇刚; 孙永恒; 任艳胜
（濮阳市人民医院泌尿外科，河南　濮阳　457000）
Author(s):
SHI Qi-gang; SUN Yong-heng; REN Yan-sheng
（Department of Urology，the People′s Hospital of Puyang，Puyang 457000，Henan Province，China）
关键词:
微创经皮肾镜取石术; 输尿管上段结石; 轻度肾积水; 炎性细胞因子
Keywords:
minimally invasive percutaneous nephrolithotomy; upper urinary calculi; mild hydronephrosis; inflammatory cytokine
分类号:
R699
DOI:
10.7683/xxyxyxb.2017.03.021
文献标志码:
A
摘要:
目的　观察微创经皮肾镜取石术治疗输尿管上段结石合并轻度肾积水的疗效及安全性。方法　选取2014年4月至2016年1月濮阳市人民医院收治的输尿管上段结石合并轻度肾积水患者100例，根据治疗方法分为观察组和对照组，每组50例，观察组患者采用微创经皮肾镜取石术治疗，对照组采用经后腹腔镜输尿管、肾盂切开取石术治疗，比较2组患者手术基本情况，术前及术后5 d时血清和尿液中白细胞介素-2（IL-2）、IL-6、肿瘤坏死因子-α（TNF-α）水平，以及术后结石清除率、并发症发生率。结果　观察组患者术中出血量显著少于对照组，手术时间、胃肠道功能恢复时间及住院时间均显著短于对照组（P<0.05）。2组患者术前血清及尿液中IL-2、IL-6、TNF-α水平比较差异均无统计学意义（P>0.05）；观察组患者术后5 d时血清IL-6、TNF-α水平显著低于术前，尿液IL-2、IL-6水平显著高于术前，TNF-α水平显著低于术前（P<0.05）；对照组患者术后5 d时血清和尿液中IL-6、TNF-α水平均显著高于术前，IL-2水平显著低于术前（P<0.05）；观察组患者术后5 d时血清、尿液中IL-6、TNF-α水平显著低于对照组，IL-2水平显著高于对照组（P>0.05）。观察组患者结石清除率为92.0%（46/50），对照组为82.0%（41/50），观察组患者结石清除率高于对照组，但2组比较差异无统计学意义（P>0.05）；观察组患者术后并发症发生率为8.0%（4/50），显著低于对照组的50.0%（25/50）（P<0.05）。结论　微创经皮肾镜取石术可有效清除合并轻度肾积水的输尿管上段结石，且对血清、尿液中炎性细胞因子影响小。
Abstract:
Objective　To observe the efficacy and safety of minimally invasive percutaneous nephrolithotomy （MPCNL） in treatment of upper urinary calculi complicated with mild hydronephrosis.Methods　One hundred patients with upper urinary calculiand and mild hydronephrosis in the People′s Hospital of Puyang from April 2014 to January 2016 were selected and divided into observation group and control group according to treatment method，with 50 patients in each group.The patients in the observation group were treated with MPCNL，while the patients in the control group were treated with laparoscopic ureterolithotomy.The basic condition，the interleukin-2（IL-2），IL-6，and tumor necrosis factor-α（TNF-α） levels in serum and urine before operation and 5 d after operation，the postoperative calculi clearance rate，and the occurrence rate of complications of patients in the two groups were compared.Results　The intraoperative blood loss of patients in the observation group was significantly less than that in the control group，and the operation time，gastrointestinal function recovery time，and hospitalization time were significantly shorter than those in the control group （P<0.05）.There was no statistic difference in IL-2，IL-6 and TNF-α levels of serum and urine before operation between the two groups （P>0.05）.The serum IL-6 and TNF-α levels at the fifth day after operation in the observation group were significantly lower than before operation （P<0.05）；the urine IL-2 and IL-6 levels at the fifth day after operation in the observation group were significantly higher than before operation （P<0.05），but the TNF-α levels were significantly lower than before operation（P<0.05）.The serum and urine IL-6 and TNF-α levels at the fifth day after operation in the control group were significantly higher than before operation，while the IL-2 levels were significantly lower than before operation （P<0.05）.The serum and urine IL-6 and TNF-α levels at the fifth day after operation in the observation group were significantly lower than those in the control group，while the IL-2 levels were significantly higher than those in the control group （P<0.05）.The calculi clearance rate in the observation group （92.0%，46/50） was higher than that in the control group （82.0%，41/50），but the difference between the two groups was not statistically significant （P>0.05）.The incidence of postoperative complications in the observation group （8.0%，4/50） was significantly lower than that in the control group （50.0%，25/50） （P<0.05）.Conclusion　MPCNL can effectively eliminate the upper urinary calculi merged with mild hydronephrosis，and has a small effect on the serum and urine inflammatory cytokines of the patients.

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更新日期/Last Update: 2017-03-05