输尿管软镜治疗小儿上尿路结石的疗效及对血清炎症因子的影响

Curative Efficacy of Ureteroscope in Treatment of Urinary Calculus in Children and Its Effects on The Effect of Serum Inflammatory Factors

目的:探讨输尿管软镜治疗小儿上尿路结石的疗效及对血清炎症因子的影响。方法:选择2013年4月至2016年4月我院收治的上尿路结石患儿60例,通过随机数表法分为观察组(n=30)和对照组(n=30),对照组给予经皮肾镜激光碎石,观察组采用输尿管软镜取石术进行治疗。观察记录两组患者术中出血量、手术时间、住院天数及疼痛评分;比较两组患者白细胞介素-10(IL-10)、C反应蛋白(CRP)、白细胞(WBC)水平、并发症发生情况及结石的清除率。结果:观察组患者手术时间、术中出血量、住院天数以及疼痛评分均低于对照组,差异均具有统计学意义(P<0.05);两组患儿术前IL-10、CRP及WBC水平无明显差异;术后两组患儿各项炎性因子均明显增加(P<0.05),观察者患儿IL-10、CRP及WBC水平显著低于对照组,差异具有统计学意义(P<0.05);术后,观察组患者并发症总发生率为6.67%,明显低于对照组的33.33%,差异具有统计学意义(P<0.05);两组患者结石清除率无明显差异(P>0.05)。结论:输尿管软镜取石术治疗上尿路结石安全有效、创伤小、并发症少,患者产生的应激反应小,值得临床推广和应用。

Objective： To study Curative efficacy of Ureteroscope in treatment of Urinary calculus in children and its effectson The effect of serum inflammatory factors. Methods： 60 patients of urinary calculus in children whoreceived therapy from April 2013 to April 2016 wereselected as research objects. The random number table method was divided into observation group（n=30） and control group（n=30）, control group was treated with percutaneous nephrolithotripsy, and the observation group was treated with ureterolithotomy.The intraoperative blood loss, operative time, length of stay and pain score were recorded in the two groups; levels of interleukin-10（il-10）, c-reactive protein（CRP）, white blood cell（WBC） and postoperative complications, clearance rate of calculuswere compared between the two groups. Results： After treatment, in the observation group, the operation time, intraoperative blood loss, length of hospital stay and pain score were all lower than the control group, and the differences were statistically significant（P〈0.05）; there was no significant difference between il-10, CRP and WBC in the two groups. The inflammatory factors were significantly increased in both groups（P〈0.05）, and the levels of il-10, CRP and WBC in the children were significantly lower than those in the control group, and the difference was statistically significant（P〈0.05）; after the operation, the total incidence of complications in the observation group was 6.67%,significantly lower than 33.33% in the control group, and the difference was statistically significant（P〈0.05）; There was no significant difference in the clearance rate between the two groups（P〉0.05）. Conclusion： Treatment of ureteral nephrolithotomy for the treatment of urinary calculi is safe and effective, small in trauma, high in removal of calculi, fewer complications, and the patient has little stress response, which is worthy of clinical promotion and application.