[1]郑继仁.输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效及对并发症的影响[J].医学信息,2025,38(01):101-104136.[doi:10.3969/j.issn.1006-1959.2025.01.018]
　ZHENG Jiren.Clinical Efficacy of Flexible Ureteroscope and Percutaneous Nephrolithotripsy in the Treatment of Larger Renal and Ureteral Calculi and its Influence on Complications[J].Journal of Medical Information,2025,38(01):101-104136.[doi:10.3969/j.issn.1006-1959.2025.01.018]
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输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效及对并发症的影响()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
38卷
期数:
2025年01期
页码:
101-104136
栏目:
论著
出版日期:
2025-01-01

文章信息/Info

Title:
Clinical Efficacy of Flexible Ureteroscope and Percutaneous Nephrolithotripsy in the Treatment of Larger Renal and Ureteral Calculi and its Influence on Complications
文章编号:
1006-1959（2025）01-0101-05
作者:
郑继仁
铅山县人民医院泌尿外科，江西 铅山 334500
Author(s):
ZHENG Jiren
Urology Department of Yanshan County People’s Hospital, Yanshan 334500, Jiangxi, China
关键词:
输尿管软镜碎石术; 经皮肾镜碎石术; 肾结石; 应激反应; 炎症反应
Keywords:
Ureteroscope;  Percutaneous nephrolithotripsy;  Renalcalculi;  Stress reaction;  Inflammatory response
分类号:
R692.4
DOI:
10.3969/j.issn.1006-1959.2025.01.018
文献标志码:
A
摘要:
目的 比较输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效及对并发症的影响。方法 选取2020年6月-2023年6月铅山县人民医院收治的较大肾输尿管结石患者60例为研究对象，根据随机数字表法将其分成对照组和观察组，每组30例，对照组行经皮肾镜碎石术，观察组行输尿管软镜碎石术。比较两组手术指标（手术时间、术中出血量、留置导尿管时间、住院时间）、应激反应指标[中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、超氧化物歧化酶（SOD）、丙二醛（MDA）]、炎症反应[白细胞介素-10（IL-10）、C反应蛋白（CRP）和白细胞计数（WBC）]和并发症（输尿管水肿、血尿、肾包膜下血肿）发生率。结果 观察组手术时间长于对照组，术中出血量、留置导尿管时间、住院时间短于对照组（P＜0.05）。术后24 h，观察组nGAL、MDA水平低于对照组，SOD水平高于对照组（P＜0.05）。观察组IL-10、CRP及WBC水平均低于对照组（P＜0.05）。观察组并发症发生率低于对照组（P＜0.05）。结论 输尿管软镜与经皮肾镜碎石术治疗较大肾输尿管结石的临床疗效都较好，但输尿管软镜碎石术对患者手术创伤更小，术后应激反应程度以及并发症发生率低，不会给患者带来较强的损伤或炎症反应。
Abstract:
Objective To compare the clinical efficacy and complications of flexible ureteroscopy and percutaneous nephrolithotomy in the treatment of large renal and ureteral calculi. Methods A total of 60 patients with large renal and ureteral calculi admitted to Yanshan County People′s Hospital from June 2020 to June 2023 were selected as the research objects. According to the random number table method, they were divided into control group and observation group, with 30 patients in each group. The control group underwent percutaneous nephrolithotripsy, and the observation group underwent flexible ureteroscopic lithotripsy. The operation indexes (operation time, intraoperative blood loss, indwelling catheter time, hospitalization time), stress response indexes [neutrophil gelatinase-associated lipocalin (NGAL), superoxide dismutase (SOD), malondialdehyde (MDA)], inflammatory response [interleukin-10 (IL-10), C-reactive protein (CRP) and white blood cell count (WBC)] and the incidence of complications (ureteral edema, hematuria, renal subcapsular hematoma) were compared between the two groups. Results The operation time of the observation group was longer than that of the control group, and the intraoperative blood loss, indwelling catheter time and hospitalization time were shorter than those of the control group (P<0.05). At 24 h after operation, the levels of nGAL and MDA in the observation group were lower than those in the control group, and the level of SoD was higher than that in the control group (P<0.05). The levels of IL-10, CRP and WBC in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group was lower than that in the control group (P<0.05). Conclusion The clinical efficacy of flexible ureteroscopy and percutaneous nephrolithotomy in the treatment of large renal and ureteral calculi is better, but flexible ureteroscopy lithotripsy has less surgical trauma, lower postoperative stress response and lower incidence of complications, and will not bring strong damage or inflammatory response to patients.

参考文献/References:

[1]顾鑫,王岸迪,景立伟,等.输尿管软镜碎石术与微通道经皮肾镜碎石术治疗1.5~3.0cm肾下盏结石比较研究[J].临床军医杂志,2021,49(7):799-800,803.[2]王雷雨,张前进,赵先诚,等.气压弹道碎石术与经皮肾通道输尿管软镜钬激光碎石术治疗复杂性肾结石的临床疗效比较[J].临床和实验医学杂志,2023,22(7):704-707.[3]周航,吴石萍,谢明,等.输尿管软、硬镜与微创经皮肾镜治疗输尿管上段复杂结石的疗效分析[J].检验医学与临床,2023,20(8):1050-1052,1056[4]余曜,李白,包伟.微创经皮肾镜、输尿管软硬镜治疗输尿管上段复杂结石的临床效果对比分析[J].临床误诊误治,2023,36(1):116-119.[5]李思宁,朱砂,苏劲,等.输尿管软镜碎石术与经皮肾镜取石术治疗直径2~4cm肾结石的临床疗效对比[J].中华实验外科杂志,2023,40(4):750-754.[6]朱澄村,程帆,余伟民,等.输尿管软镜碎石术与微通道经皮肾镜取石术治疗<1.5cm肾下盏结石的有效性和安全性比较[J].中华泌尿外科杂志,2023,44(1):32-36.[7]王培龙,李笑然,何藄琪,等.单通道经皮肾镜取石术联合输尿管软镜与输尿管软镜钬激光碎石术治疗复杂性肾结石的效果比较[J].实用临床医药杂志,2023,27(2):101-104,112.[8]丁琪,范波,朱海亮,等.斜仰卧截石位下超微通道经皮肾镜联合输尿管软镜治疗2.0～3.0cm肾结石的临床疗效分析[J].现代泌尿外科杂志,2023,28(9):759-763.[9]古月,魏仁波,严沁,等.输尿管上段结石微通道经皮肾镜和经尿道输尿管软镜钬激光碎石术对患者肾功能、血流动力学及血气指标的影响[J].实用医院临床杂志,2022,19(4):64-67.[10]段成斌,王资斌.输尿管软镜钬激光碎石术与微创经皮肾镜碎石术治疗2~3cm肾结石的效果及安全性比较[J].实用医院临床杂志,2022,19(4):128-131.[11]徐晓健,张俊,陈宗薪,等.微通道经皮肾镜联合输尿管软镜与输尿管软镜钬激光碎石术治疗复杂肾结石疗效及对肾功能的影响[J].临床和实验医学杂志,2022,21(3):313-317.[12]罗靖,龙家才,李昕,等.输尿管软镜碎石术与微通道经皮肾镜碎石术治疗2~3cm上尿路结石的有效性和安全性[J].现代泌尿外科杂志,2022,27(3):242-245.[13]张光耀.微通道经皮肾镜取石术联合输尿管软镜钬激光碎石术治疗复杂肾结石的效果观察[J].中国临床医生杂志,2022,50(10):1196-1198.[14]黄志强,李虎,马楠,等.输尿管软镜及微造瘘经皮肾镜碎石治疗肾下盏结石的临床疗效及对血清降钙素原、C反应蛋白、白细胞介素-6水平的影响[J].临床外科杂志,2021,29(11):1068-1070.[15]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.[16]陈科梁,鲁佩,张炜,等.分层分析比较超微经皮肾镜与输尿管软镜治疗1.5~2.5cm肾结石的临床观察[J].现代泌尿外科杂志,2020,25(12):1069-1074.[17]黄裕棱,李卓航,刘成,等.斜跨位多通道经皮肾镜碎石术与单通道经皮肾镜联合输尿管软镜碎石术治疗鹿角形肾结石的疗效对比[J].中华医学杂志,2021,101(38):3121-3126.[18]张朝阳,周舰,杨军,等.侧卧位单通道微创经皮肾镜取石术与输尿管软镜碎石术治疗成人肾结石临床效果比较[J].临床军医杂志,2021,49(7):791-792.[19]陈爽,李守燕,彭继超.微通道经皮肾镜碎石取石术和逆行输尿管软镜碎石取石术治疗2～4cm肾下盏结石的临床疗效观察[J].实用医院临床杂志,2021,18(6):125-128.

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更新日期/Last Update: 1900-01-01