经皮肾镜一期与温肾排石汤结合治疗肾盂旁囊肿合并肾结石患者效果观察

Observation on the effect of the first-stage percutaneous nephroscope combined with wenshenpaishi decoction in the treatment of patients with para-pelvic cyst complicated with renal calculi

目的:探讨分析经皮肾镜一期与温肾排石汤结合治疗肾盂旁囊肿合并肾结石临床效果。方法:选取2010年1月至2018年12月收治的80例肾盂旁囊肿合并肾结石患者随机分为观察组和对照组。观察组给予经皮肾镜一期结合温肾排石汤治疗,对照组仅给予经皮肾镜一期治疗,比较两组清石率、二期手术率、治疗前后肾功能指标、治疗前后炎性因子水平、术后复发情况。结果:观察组、对照组14 d后清石率(95.00%vs 92.50%)、二期手术率(5.00%vs 7.50%),差异无统计学意义(P>0.05);治疗前两组肾功能指标水平差异无统计学意义(P>0.05),治疗后两组β2-MG、CysC、NGAL、尿血红蛋白水平均显著下降,且观察组β2-MG、CysC、NGAL、尿血红蛋白水平下降更显著,差异均具有统计学意义(P<0.05);治疗前两组炎性因子水平差异无统计学意义(P>0.05),治疗后两组CRP、IL-6、TNF-α、IL-1β水平均显著下降,且观察组CRP、IL-6、TNF-α、IL-1β水平下降更显著,差异均具有统计学意义(P<0.05);两组患者随访2年均未出现肾盂旁囊肿复发。结论:经皮肾镜一期治疗肾盂旁囊肿合并肾结石疗效确切,与常规手术相比优势显著,辅以温肾排石汤治疗有助于降低炎性因子水平,保护患者的肾功能,值得在临床上推广。

Objective:To analyze the clinical effect of percutaneous nephroscope combined with wenshenpaishi decoction in the treatment of para-pelvic cysts complicated with renal calculi.Methods:80 patients with para-pelvic cyst complicated with renal calculus admitted from January 2010 to December 2018 were randomly divided into the observation group and the control group.The observation group were given the first-stage percutaneous nephroscope combined with wenshenpaishi decoction,while the control group were given only the first-stage percutaneous nephroscope,with the rates of clearing stones,the second-stage operation,the renal function and inflammatory factor levels before and after treatment and postoperative recurrence rates compared.Results:14 days after the treatment,the rates of clearing stones(95.00%vs 92.50%)and the rates of the second-stage operation(5.00%vs 7.50%)were observed in the observation group and the control group,the difference being not statistically significant(P>0.05).There was no significant difference in the levels of functional indicators before treatment(P>0.05).After treatment,the levels ofβ2-MG,CysC,NGAL and urinary hemoglobin in both groups decreased significantly,with those of the observation group decreased more significantly,the differences being statistically significant(P<0.05).There was no significant difference in the levels of inflammatory factors between the two groups before treatment(P>0.05).The levels of CRP,IL-6,TNF-αand IL-1βin both groups decreased after treatment,with those of the observation group decreased more significantly,the difference being statistically significant(P<0.05).There was no recurrence of para-pelvic cysts in both groups after 2 years of follow-up.Conclusion:The first-stage percutaneous nephroscope is effective in the treatment of para-pelvic cyst complicated with renal calculi,with a significant advantage over conventional surgery.If assisted with wenshenpaishi decoction,the first-stage percutaneous nephroscope can help reduce the levels of inflammatory factors and protect the renal function of patients,worthy of clinical promotion.