用电子输尿管软镜手术治疗肾结石的效果观察

Observation of the effect of electronic flexible ureteroscopy in the trea tment of renal calculi

目的:探讨用电子输尿管软镜手术治疗肾结石的临床效果。方法:将2017年11月至2020年1月期间广东省珠海市遵义医科大学附属第五医院收治的65例肾结石患者作为研究对象。将这65例患者分为参照组(n=32)和试验组(n=33)。对参照组患者进行经皮肾镜取石术,对试验组患者进行电子输尿管软镜手术。然后,比较两组患者血肌酐的水平、血清胱抑素-C(Cys-C)的水平、血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的水平和尿肾脏损伤分子-1(Kim-1)的水平。结果:在术前和术后的第12 h、第24 h、第48 h、第72 h,两组患者血肌酐的水平相比,P>0.05。在术后的第12 h和第24 h,两组患者血肌酐的水平均达到峰值;从术后的第48 h开始,两组患者血肌酐的水平逐渐降低;在术后的第72 h,两组患者血肌酐的水平接近术前其血肌酐的水平。在术后的第24 h,与参照组患者相比,试验组患者血清Cys-C的水平、血清NGAL的水平和尿Kim-1的水平均更低,P<0.05。结论:用电子输尿管软镜手术治疗肾结石的效果显著,可明显减少对患者肾功能的影响。

Objective:To investigate the clinical effect of electronic flexible ureteroscopy in the treatment of renal calculi.Methods:65 patients with kidney stones admitted to the Fifth Affiliated Hospital of Zunyi Medical University,Zhuhai city,Guangdong Province from November 2017 to January 2020 were studied.The 65 patients were divided into the reference group(n=32)and the experimental group(n=33).Percutaneous nephrolithotomy was performed in the reference group,and electronic flexible ureteroscopy was performed in the experimental group.Serum cystatin C(CYS-C),serum neutrophil gelatinase-associated lipid carrier protein(NGAL),and urinary kidney injury molecule-1(KIM-1)levels were then compared between the two groups.Results:at 12 h,24 h,48 h,and 72 h before and after surgery,the serum creatinine levels of the two groups were compared,P>0.05.At the 12th and 24th h after surgery,the serum creatinine levels in both groups reached the peak.From the 48th h after surgery,the serum creatinine level of patients in both groups decreased gradually.At 72 h after surgery,the serum creatinine levels in both groups were close to those before surgery.At 24 h after surgery,compared with the control group,serum CYS-C,serum NGAL and urine KIM-1 levels in the experimental group were all lower(P<0.05).Conclusion:Electronic flexible ureteroscopy is effective in the treatment of renal calculi and can significantly reduce the impact on renal function.