输尿管硬镜联合瑞邦阻石网篮钬激光碎石术治疗输尿管上段结石疗效及对患者肾功能、氧化应激的影响

Curative effect of rigid ureteroscope combined with Ribon’s stone-blockade net basket holmium laser lithotripsy on upper ureteral calculi and its influences on renal function and oxidative stress of patients

目的:研究输尿管硬镜联合瑞邦阻石网篮钬激光碎石术治疗输尿管上段结石疗效及对患者肾功能、氧化应激的影响。方法:选取2019年1月~2021年1月于本院收治的300例输尿管上段结石患者,根据数字表法分为对照组(输尿管硬镜钬激光碎石术)和治疗组(输尿管硬镜联合瑞邦阻石网篮钬激光碎石术)各150例。比较两组的围手术期相关指标(手术时间、术中出血量、术后住院时间)和手术疗效(手术成功率、结石清除率),以及肾功能指标(血清胱抑素C(CysC)、血肌酐(Cr))、氧化应激指标(肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP))和并发症发生率。结果:术后1个月,治疗组的手术成功率为96.00%、结石清除率为94.67%,均高于对照组的88.00%和86.00%;治疗组手术时间长于对照组,住院时间短于对照组;术后两组的CysC、Cr水平均有降低,其中治疗组降低幅度更明显;术后两组的TNF-α、CRP水平均有降低,治疗组降低幅度更明显;治疗组的并发症发生率为3.33%,低于对照组的9.33%。结论:输尿管硬镜联合瑞邦阻石网篮钬激光碎石术治疗输尿管上段结石,疗效良好,住院时间短,患者术后肾功能恢复较好,应激反应较少,安全性高。

Objective To study the curative effect of rigid ureteroscope combined with Ribon’s stone-blockade net basket holmium laser lithotripsy on upper ureteral calculi and its influences on renal function and oxidative stress of patients.Methods A total of 300 patients with upper ureteral calculi admitted to the hospital from January 2019 to January 2021 were enrolled and divided into control group(rigid ureteroscopic holmium laser lithotripsy)and treatment group(rigid ureteroscope combined with Ribon’s stone-blockade net basket holmium laser lithotripsy)according to random number table method,150 cases in each group.The perioperative indexes(operation time,intraoperative blood loss,postoperative hospitalization time),surgical effect(surgical success rate,stone clearance rate),renal function indexes[serum cystatin C(CysC),serum creatinine(Cr)],oxidative stress indexes[tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and incidence of complications were compared between the two groups.Results At 1 month after surgery,surgical success rate and stone clearance rate in treatment group were 96.00%and 94.67%,higher than those in control group(88.00%,86.00%).The operation time in treatment group was longer than that in control group,and hospitalization time was shorter than that in control group.After surgery,levels of CysC and Cr in both groups were decreased,whose decrease was more significant in treatment group.After surgery,levels of TNF-α and CRP in both groups were decreased,whose decrease was more significant in treatment group.The incidence of complications in treatment group was lower than that in control group(3.33%vs 9.33%).Conclusion Curative effect of rigid ureteroscope combined with Ribon’s stone-blockade net basket holmium laser lithotripsy is good on upper ureteral calculi,with short hospitalization time,good postoperative recovery of renal function,few stress responses and high safety.