切开取石术对输尿管上段结石并感染患者肾功能及血清炎症因子的影响

Effects of Retroperitoneal Laparoscopic Ureterolithotomy on Renal Function and Serum Inflammatory Cytokines in Patients having Upper Ureteral Calculi with Infection

目的探讨后腹腔镜输尿管切开取石术(RPLU)对输尿管上段结石并感染患者肾功能及血清炎症因子的影响。方法选取我院收治的行RPLU治疗的输尿管上段结石并感染的40例为观察组,选取同期行输尿管内碎石术(URST)治疗的输尿管上段结石并感染的37例为对照组。观察两组术前及术后肾功能、炎症因子水平变化,比较手术及住院时间,记录并发症发生情况。结果与本组术前比较,两组术后1 d明胶原相关脂质运载蛋白(NGAL)、白细胞介素(IL)-6、C-反应蛋白(CRP)水平均升高,术后7 d白细胞、IL-6、CRP水平明显降低,差异有统计学意义(P<0.05);与对照组比较,观察组术后1 d NGAL水平显著降低,IL-6、CRP水平升高,差异有统计学意义(P<0.05)。两组并发症发生情况比较差异有统计学意义(χ2=4.699,P=0.03),但住院及手术时间比较差异无统计学意义(P>0.05)。结论 RPLU能有效改善输尿管上段结石并感染患者的肾功能,降低炎症因子水平,且术后并发症较少。

Objective To investigate effects of retroperitoneal laparoscopic ureterolithotomy（ RPLU） on renal function and serum inflammatory cytokines in patients having upper ureteral calculi with infection. Methods Forty patients having upper ureteral calculi with infection receiving RPLU in our hospital were enrolled as observation group,and 37 patients suffering upper ureteral calculi with infection treated by ureteral lithotripsy（ URST） at the same period served as the control group. Renal function,the levels of inflammatory factors before and after operation,duration of operation and length of hospital stay in two groups were observed,and the occurrence of complications was recorded. Results The levels of Neutrophil Gelatinase Associated Lipocalin（ NGAL）,interleukin（ IL）-6 and Creactive protein（ CRP） in the two groups were increased at 1 day after operation,whereas the levels of leukocyte,IL-6 and CRP were decreased significantly at 7 days after operation as compared with those before operation,and the difference was statistically significant（ P〈0. 05）. Compared with the control group,the levels of NGAL in the observation group were decreased significantly,whereas the levels of IL-6 and CRP were increased at 1 day after operation,showing significant difference（ P〈0. 05）. There was significant difference in the incidence of complications between the two groups（ χ^2= 4. 699,P = 0. 03）,but the length of hospital stay and the duration of operation did not differ significantly in two groups（ P〉0. 05）. Conclusion RPLU can effectively restore the renal function and decrease the level of inflammatory factors in patients having upper ureteral calculi with infection,leading to minimal complications.