B超引导下穿刺输尿管镜治疗小儿肾结石的疗效及其对肾功能和部分炎症指标的影响

Effects of puncture ureteroscopy guided by B-ultrasound in the treatment of children with kidney stones and its influence on renal function and some inflammation indexes

目的探讨B超引导下穿刺输尿管镜治疗小儿肾结石的疗效及其对肾功能和血清炎症指标的影响。方法选取该院于2010年1月至2015年1月收治的110例肾结石患儿,根据其不同的治疗方法将110例患儿分为观察组及对照组。观察组76例患儿应用B超引导下穿刺输尿管镜治疗,对照组44例患儿应用传统开放手术治疗。比较两组患儿手术时间、失血量、术后一般情况、术后肾功能恢复情况及手术前后的炎症指标变化情况。结果观察组患儿的手术时间及失血量均低于对照组(P<0.05)。观察组患儿术后留置造瘘管时间、住院时间及进食时间均短于对照组(P<0.05),但一期结石清除率比较,差异无统计学意义(P>0.05)。术后3 d及2周观察组患儿的肾功能优于对照组(P<0.05)。两组患儿手术前后的炎症因子C反应蛋白、肿瘤坏死因子-α、核因子-κB及白细胞介素-1水平比较,差异无统计学意义(P>0.05)。结论与传统开放手术比较,B超引导下穿刺输尿管镜治疗小儿肾结石损伤小,术后恢复快,并发症少,且不会加重机体炎性反应。

Objective To investigate the effects of puncture and ureteroscopy guided by B-ultrasound in the treatment of children with kidney stones and its influence on renal function and some serum inflammation indexes.Methods A total of 110 pediatric kidney stone children admitted to the hospital from January 2010 to January 2015 were selected.According to their different treatment methods,110 children were divided into observation group and control group.Among them,76 cases in the observation group were treated with B-guided puncture and ureteroscopy,and 44 cases in the control group were treated with traditional open surgery.The operation time,blood loss,general postoperative conditions,postoperative renal function recovery and changes in inflammation indicators before and after the operation were compared between the two groups.Results The operation time and blood loss of the observation group were lower than those of the control group(P<0.05).The postoperative indwelling fistula time,hospitalization time and eating time of the observation group were lower than those of the control group(P<0.05),but there was no significant difference in the first-stage stone clearance rate(P>0.05).The renal function of the observation group was better than that of the control group 3 d after operation and 2 weeks after operation(P<0.05).There was no significant difference in the levels of inflammatory factor C reactive protein,tumor necrosis factor-α,nuclear factor-κB and interleukin-1 in the two groups before and after treatment(P>0.05).Conclusion Compared with traditional open surgery,puncture and ureteroscopy by B-ultrasound for children with renal calculus has less damage,faster recovery after surgery,fewer complications,and does not increase the body′s inflammatory response.