负压吸引组合式输尿管镜与输尿管软镜治疗感染性肾结石的对比分析

Comparative Analysis of Negative Pressure Suction Combined Ureteroscopy and Ureteroscopy for the Treatment of Infectious Kidney Stones

目的:比较负压吸引组合式输尿管镜与输尿管软镜治疗感染性肾结石的效果。方法:将108例感染性肾结石患者随机分为两组各54例,对照组采取输尿管软镜治疗,观察组采取负压吸引组合式输尿管镜治疗。比较两组术中肾盂压力、一次碎石清除率、结石排尽时间、超敏C-反应蛋白(hs-CRP)、降钙素原(PCT)、白细胞介素6(IL-6)、血肌酐(Scr)、尿素氮(BUN)、中性粒细胞明胶酶相关载脂蛋白(NGAL)。结果:观察组术中肾盂压力明显低于对照组,一次碎石清除率明显高于对照组,结石排尽时间明显短于对照组,比较有统计学意义(P<0.05)。两组术后hs-CRP、PCT、IL-6水平均升高,但观察组明显低于对照组,比较有统计学意义(P<0.05)。两组手术前后Scr、BUN、NGAL均无明显变化,且组间比较无统计学意义(P>0.05)。结论:与输尿管软镜相比,负压吸引组合式输尿管镜能够减小术中肾盂压力,提高结石清除率,且引起的应激炎性反应更小,不过二者对肾功能均无明显影响。

Objective:To compare the effect of negative pressure suction combined ureteroscopy and ureteroscopy in the treatment of infectious kidney stones.Methods:108 patients with infectious kidney stones were randomly divided into two groups of 54 patients,the control group was treated with ureteroscopy,and the research group was treated with negative pressure suction combined ureteroscopy.Intraoperative renal pelvis pressure,one-time debris removal rate,stone depletion time,high-sensitivity C-reactive protein(hs-CRP),procalcitonin(PCT),interleukin-6(IL-6),blood creatinine(Scr),urea nitrogen(BUN),neutrophil gelatinase-associated apolipoprotein(NGAL).Results:The intraoperative renal pelvis pressure in the study group was significantly lower than that in the control group,the one-time debris removal rate was significantly higher than that in the control group,and the stone depletion time was significantly shorter than that in the control group(P<0.05).Postoperative hs-CRP,PCT and IL-6 levels increased in both groups,but the study group was significantly lower than the control group,and the difference was statistically significant(P<0.05).There were no significant changes in Scr,BUN,and NGAL before and after surgery in both groups,and there was no statistical significance between the two groups(P>0.05).Conclusion:Compared with soft ureteroscopy,negative pressure suction combined ureteroscopy can reduce intraoperative renal pelvis pressure,improve stone clearance,and cause less stress inflammatory response,but neither has significant effect on renal function.