| 朱家利,汪 溢,姚泽钦,罗后宙,霍振清,梁 冰.后腹腔镜输尿管切开取石术对上尿路结石患者炎性因子及肾功能的影响[J].,2019,19(16):3175-3178 |
| 后腹腔镜输尿管切开取石术对上尿路结石患者炎性因子及肾功能的影响 |
| Effect of Retroperitoneal Laparoscopic Ureterolithotomy on Inflammatory Factors and Renal Function in Patients with Upper Urinary Tract Calculi |
| 投稿时间：2019-01-21 修订日期：2019-02-19 |
| DOI：10.13241/j.cnki.pmb.2019.16.036 |
| 中文关键词: 后腹腔镜输尿管切开取石术 上尿路结石 炎性因子 肾功能 经输尿管镜取石术 |
| 英文关键词: Retroperitoneal laparoscopic ureterolithotomy Upper urinary tract calculi Inflammatory factors Renal function Transureteroscopic lithotripsy |
| 基金项目:海南省医药卫生科研项目（16A201151） |
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| 中文摘要: |
| 摘要 目的：探讨后腹腔镜输尿管切开取石术（RLU）对上尿路结石患者炎性因子及肾功能的影响。方法：选取2016年1月~2018年11月期间海南省第三人民医院泌尿外科收治的上尿路结石患者89例为研究对象，根据手术方式的不同将患者分为RLU组（n=44）和经输尿管镜取石术（URL）组（n=45），比较两组患者手术成功率、结石取净率、炎性因子指标[白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、内皮素-1（ET-1）、C反应蛋白（CRP）]、肾功能指标[血尿素氮（BUN）、血肌酐（Scr）、明胶酶相关脂质运载蛋白（NGAL）]及术后并发症。结果：RLU组患者手术成功率、结石取净率均高于URL组（P<0.05）。两组患者术后1d IL-6、TNF-α、ET-1以及CRP水平均较术前升高，但RLU组低于URL组（P<0.05）。两组患者术后1d BUN、Scr水平比较差异均无统计学意义（P>0.05），两组患者术后1d NGAL水平较术前升高，但RLU组低于URL组（P<0.05）。RLU组术后并发症发生率低于URL组（P<0.05）。结论：RLU对上尿路结石患者的炎症刺激和肾功能影响更小，且可有效提升手术成功率、结石取净率，降低并发症发生率，有利于患者术后恢复。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of retroperitoneal laparoscopic ureterolithotomy (RLU) on inflammatory factors and renal function in patients with upper urinary tract calculi. Methods: 89 patients with upper urinary tract stones who were admitted to the urology department of Hainan Third People's Hospital from January 2016 to November 2018 were selected as the research objects. According to the different surgical methods, the patients were divided into RLU group (n=44) and transureteroscopic lithotripsy (URL) group (n=45). The success rate of operation, stone clearance rate, inflammatory factor index [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), endothelin-1 (ET-1), C-reactive protein (CRP)], renal function index [BUN, creatinine (Scr), neutrophil gelatinase-asso-ciated lipocalin (NGAL)] and postoperative complications were compared between the two groups. Results: The success rate of operation and stone clearance rate in RLU group were higher than those in URL group (P<0.05). The levels of IL-6, TNF-α, ET-1 and CRP in the two groups at 1 day after operation were higher than those before operation, but the levels in RLU group were lower than those in URL group (P<0.05). There was no significant difference in BUN and Scr between the two groups at 1 day after operation (P>0.05). The level of NGAL in the two groups at 1 day after operation was higher than that before operation, but that in the RLU group was lower than that in the URL group (P<0.05). The incidence of postoperative complications in RLU group was lower than that in URL group (P<0.05). Conclusion: RLU has less effect on inflammatory stimulation and renal function in patients with upper urinary tract stones, and can effectively improve the success rate of operation, stone clearance rate, reduce the incidence of complications, and is conducive to the recovery of patients after operation. |
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