输尿管软镜治疗肾结石的效果及对肾损伤因子、炎症因子表达水平的影响

Effect of Ureteroscope on the Treatment of Kidney Stones and Its Effect on the Expression of Renal Injury Factors and Inflammatory Factors

目的探讨输尿管软镜治疗肾结石的效果及对患者肾损伤因子、炎症因子表达水平的影响。方法回顾性选取2015年2月至2017年11月我院收治的肾结石患者74例,根据手术方法不同分为两组。经皮肾镜治疗组患者采用标准经皮肾镜取石术治疗,输尿管镜治疗组患者输尿管软镜取石术治疗,分析两组患者治疗后的临床效果。结果输尿管镜治疗组手术时间、住院时间短于经皮肾镜治疗组,血红蛋白下降量少于经皮肾镜治疗组,但两组结石清除率比较,差异无统计学意义(P>0. 05)。术前,两组患者KIM-1、NGAL、Cys-C、应激因子水平比较,差异无统计学意义(P>0. 05)。输尿管镜治疗组术后2d时KIM-1水平低于经皮肾镜治疗组;术后1d、2d、3d时Cys-C水平高于经皮肾镜治疗组,术后同时间NGAL水平与经皮肾镜治疗组比较,差异无统计学意义(P>0. 05);术后1d、2d、3d时SOD水平高于经皮肾镜治疗组,MDA、IL-6、CRP水平低于经皮肾镜治疗组,差异有统计学意义(P<0. 05)。输尿管镜治疗组患者并发症率为13. 51%,经皮肾镜治疗组为10. 81%,输尿管镜治疗组患者并发症率与经皮肾镜治疗组比较,差异无统计学意义(P>0. 05)。结论输尿管软镜取石术治疗肾结石手术时间短,创伤小,对机体应激反应较小,且并不增加并发症率,但会肾损伤小球功能,应用时需注意肾功能的保护。

Objective To investigate the effect of ureteroscopy on the treatment of renal calculi and its effect on the expression of renal injury factors and inflammatory factors.Methods A retrospective study of 74 patients with kidney stones admitted to our hospital from February 2015 to November 2017 was divided into two groups according to different surgical methods.The patients in the percutaneous nephrolithotherapy group were treated with standard percutaneous nephrolithotomy,and the ureteroscopy group was treated with ureteroscopy.The clinical effects of the two groups were analyzed. Results In the ureteroscopy group,the operation time and hospitalization time were shorter than those in the percutaneous nephrolithotherapy group. The hemoglobin decreased less than the percutaneous nephrolithotherapy group,but there was no significant difference in the clearance rate between the two groups( P>0. 05).There were no significant differences in the levels of KIM-1,NGAL,Cys-C and stress factors between the two groups before surgery( P>0. 05).The level of KIM-1 in the ureteroscopy group was lower than that in the percutaneous nephrolithotomy group at 2 days after operation.The level of Cys-C was higher than that in the percutaneous nephrolithotherapy group at 1 d,2 d and 3 d after operation,at the same time,there was no significant difference in the level of NGAL between the two groups( P>0. 05).The SOD level at 1 d,2 d and 3 d was higher than that in the percutaneous nephrolithotherapy group.The MDA,IL-6 and CRP levels were lower than the percutaneous nephrolithotherapy group,the difference was statistically significant( P<0. 05).The complication rate was 13. 51% in the ureteroscopy group and 10. 81% in the percutaneous nephrolithotherapy group.There was no significant difference in the complication rate between the ureteroscopy group and the percutaneous nephrolithotherapy group( P>0. 05).Conclusion The ureteroscopy for the treatment of kidney stones is short,the trauma is small,the stress response to the body is small,and the complication rate is not increased,but the function of the glomerulus of the kidney is damaged. The application should pay attention to the protection of renal function.