输尿管软镜碎石术对肾结石患者肾功能、氧化应激反应及血清NGAL、WBC水平的影响

The Effects of Flexible Ureteroscopy Lithotripsy on Renal Function,Oxidative Stress Response and Serum NGAL and WBC Levels in Patients with Kidney Stones

目的探讨输尿管软镜(F-URS)碎石术在肾结石患者中的应用效果.方法选取我院2021年7月—2023年9月收治的74例肾结石患者为研究对象,采用随机数字表法将其分为对照组和观察组,各37例.对照组行经皮肾镜碎石术(PCNL)治疗,观察组行F-URS碎石术治疗.比较两组的手术情况、肾功能、氧化应激反应、血清中性粒细胞明胶酶相关载脂蛋白(NGAL)、白细胞(WBC)计数水平及并发症发生情况.结果观察组术中出血量为(10.52±1.15)mL,少于对照组的(56.88±5.43)mL,住院时间为(3.89±0.41)d,短于对照组的(6.85±1.12)d,组间差异有统计学意义(P<0.05).术后,观察组血尿素氮、血肌酐、半胱氨酸蛋白酶抑制剂C水平分别为(10.35±1.22)mmol/L、(88.04±6.75)μmol/L、(613.41±50.28)μg/L,均低于对照组的(14.55±1.34)mmol/L、(96.81±6.84)μmol/L、(673.68±50.75)μg/L,组间差异有统计学意义(P<0.05).术后,观察组丙二醛水平为(1.68±0.23)mmol/L,低于对照组的(1.97±0.27)mmol/L,超氧化物歧化酶水平为(80.57±5.82)U/mL,高于对照组的(75.41±5.36)U/mL,组间差异有统计学意义(P<0.05).术后,观察组NGAL、WBC水平均低于对照组,组间差异有统计学意义(P<0.05).两组并发症发生率比较,差异无统计学意义(P>0.05).结论F-URS碎石术治疗肾结石效果更佳,可减轻肾功能损伤,降低氧化应激反应,避免血清NGAL、WBC过度异常.

Objective To investigate the effect of flexible ureteroscopy(F-URS)lithotripsy in the treatment of kidney stones.Methods 74 patients with kidney stones admitted to our hospital from July 2021 to September 2023 were selected as the study objects and randomly divided into a control group and an observation group,37 cases in each group.The control group was treated with percutaneous nephrolithotripsis(PCNL),and the observation group was treated with F-URS.The operation conditions,renal function,oxidative stress,serum neutrophil gelatinase-associated apolipoprotein(NGAL),white blood cell(WBC)count and complications were compared between the two groups.Results The intraoperative blood loss in the observation group was(10.52±1.15)mL,which was less than the control group's(56.88±5.43)mL,and the hospital stay was(3.89±0.41)d,which was shorter than the control group's(6.85±1.12)d,and the differences between the groups were statistically significant(P<0.05).After surgery,the blood urea nitrogen,creatinine,and cysteine protease inhibitor C in the observation group were(10.35±1.22)mmol/L,(88.04±6.75)μmol/L,(613.41±50.28)μg/L,respectively,lower than the control group's(14.55±1.34)mmol/L,(96.81±6.84)μmol/L,(673.68±50.75)μg/L,and there were statistically significant difference between groups(P<0.05).After surgery,the level of malondialdehyde in the observation group was(1.68±0.23)mmol/L,which was lower than the control group's(1.97±0.27)mmol/L,and the level of superoxide dismutase was(80.57±5.82)U/mL,which was higher than the control group's(75.41±5.36)U/L,and there were statistically significant difference between the groups(P<0.05).After surgery,the levels of NGAL and WBC in the observation group were lower than those in the control group,and there were statistically significant difference between the groups(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion F-URS lithotripsy is more effective in the treatment of kidney stones,can reduce renal function injury,reduce oxidative stress reaction,avoid excessive abnormal serum NGAL and WBC.