微创经皮肾穿刺取石术对肾结石患者术后应激反应影响

Postoperative stress response in patients with renal calculus after minimally invasive percutaneous nephrolithotrips

目的探讨微创经皮肾穿刺取石术治疗肾结石对机体应激反应的影响。方法回顾分析2004年2月～2008年10月收治的肾结石患者中取微创经皮肾取石术46例(微创组),肾切开取石术36例(开腹组)患者资料。手术当日晨及术后3h和24h采集患者外周静脉血测定皮质醇、白介素-6(IL-6)、C-反应蛋白(CRP)和血糖水平。结果术后3h,两组患者术后皮质醇、IL-6、CRP及血糖水平明显高于术前(P均<0.05);3h和24h,开腹组患者的皮质醇、IL-6、CRP及血糖水平明显高于微创组(P均<0.05)。结论微创经皮肾取石术治疗肾结石患者术后应激反应小于开腹手术,这有利于手术患者的术后恢复。

Objective To explore the effect of minimally invasive percutaneous nephrolithotrips（MPCNL）on stress response of patients with renal calculus.Methods From February 2004 to October 2008,82 cases renal calculus received operation were analyzed retrolspectively.Among them,46 cases underwent MPCNL（MG）and 36 cases underwent open operation（OG）.Peripheral blood samples were obtained preoperatively and 3 h,24 h after operation for measuring cortisol,IL-6,C-response protein and glucose.Result The levels of cortisol,IL-6,CRP and glucose in both OG and MG were remarkably higher at 3 h postoperatively than that at preoperation.The levels of cortisol,IL-6,CRP and glucose in the OG was much higher than that MG（P0.05）.Conclusion The results of this study indicate that minimally invasive percutaneous nephrolithotrips possesses less influence on stress response of patients with renal calculus than that OG.This might suggest the quick recovery of the patients receiving MPCNL.