经尿道输尿管镜及经皮肾镜治疗输尿管结石对机体的创伤程度比较

Comparing of the trauma degree between minimally invasive percutaneous nephrolithotomy and transurethral ureteroscopic lithotripsy for upper ureteric calculi

目的通过测定经皮肾输尿管镜取石术(MPCNL)与经尿道输尿管镜取石术(URL)治疗合并感染的输尿管结石过程中,血清C反应蛋白(CRP)浓度的改变,比较两种术式对机体的创伤程度,为选择手术方式提供依据。方法选择2006年4至12月在本院住院手术治疗的合并感染的输尿管结石患者76例,根据手术适应症分组,36例接受MPCNL,40例接受URL。分别于术前24h,手术后2、24、72h测定血清CRP含量,比较两组间有无差异。结果两组患者在性别、年龄、病程等方面及术前24h、术后72hCRP含量差异无显著性(P>0.05);但术后2、24h两组间CRP含量MPCNL组低于URL组(P>0.05);结论对于合并感染的输尿管结石的治疗,MPCNL对机体全身的创伤小于URL。

Objective To compare and evaluate the trauma degree between minimally invasive percutaneous nephrolithotomy （MPCNL）and trans-ureteroscope lithotripsy （URL）by comparing the level of C-reaction protein in serum in the process of treating ureter stones and concurrent infection. Methods In our In-patient Department, 76 patients suffering from ureter stones and concurrent infection cases were chosen. According to operation indication, 36 patients underwent PCNL and 40 cases underwent URL respectively. The level of C-reaction protein in serum was monitored the on the last day before operation, at the second hour, on the first day and third day after operation. Results The differences between the two groups in the sex, age, course and the level of C-reaction protein in serum on the last day preoperatively and third day postoperatively was not significant（P〉0.05）. However, the level of C-reaction protein in serum of the PCNL group was less than the URL group at the second hour and in the first day postoperatively（P〈0.05）. Conclusions In the process of curing ureter stones and concurrent infection, PCNL brought less trauma to the body than URL.