输尿管软镜钬激光碎石术与经皮肾镜碎石术对输尿管上段复杂性结石患者术后炎症反应的影响

Effect of Flexible Ureteroscope Holmium Laser Lithotripsy and Percutaneous Nephrolithotomy on Postoperative Inflammatory Response in Patients With Complex Upper Ureteral Calculi

目的探究输尿管软镜钬激光碎石术与经皮肾镜碎石术对输尿管上段复杂性结石患者术后炎症反应的影响。方法选取收治的输尿管上段复杂性结石患者70例进行回顾性分析,依据术式将其分为输尿管软镜钬激光碎石术组(软镜组)35例和经皮肾镜碎石术组(肾镜组)35例,对比分析两种术式的效果以及对患者术后炎症反应的影响。结果两组患者的术后出血、感染发生率无统计学差异(P>0.05)。软镜组手术用时明显长于肾镜组(P<0.05),其术中出血量、住院周期显著短于肾镜组(P<0.05)。与术前相比,两组患者的外周血白细胞计数(WBC)、C-反应蛋白(CRP)、皮质醇(Cor)、白介素-6(1L-6)以及白介素-10(1L-10)水平均有明显提高(P<0.05),但软镜组患者炎症反应各指标升高水平均显著低于肾镜组(P<0.05)。结论输尿管软镜钬激光碎石术较经皮肾镜碎石术输尿管上段复杂性结石的治疗中对机体的后炎症反应较小,缩短患者住院周期,术中出血少,较为安全。

Objective To explore the effects of flexible ureteroscope holmium laser lithotripsy and percutaneous nephrolithotomy on postoperative inflammatory response in patients with complex upper ureteral calculi.Methods Totally 70 patients with complex upper ureteral calculi admitted to this hospital were selected for retrospective analysis,and the patients were divided into flexible ureteroscope holmium laser lithotripsy group(the flexible ureteroscope group,35 cases)and percutaneous nephrolithotomy group(the nephroscope group,35 cases).The effects of the two surgical methods and the influence on postoperative inflammatory response of patients were compared and analyzed.Results There were no significant differences in the incidence rates of postoperative blood loss and infection between the two groups(P>0.05).The surgical time in the flexible ureteroscope group was significantly longer than that in the nephroscope group(P<0.05),and the intraoperative blood loss and hospitalization cycle were significantly shorter than those in the nephroscope group(P<0.05).Compared with before surgery,the peripheral blood white blood cell count(WBC),C-reactive protein(CRP),cortisol(Cor),interleukin-6(1L-6)and interleukin-10(1L-10)in the two groups were significantly improved(P<0.05),but the increases of various indicators of inflammatory response in the flexible ureteroscope group were significantly lower than those in the nephroscope group(P<0.05).Conclusion Flexible ureteroscope holmium laser lithotripsy has milder body’s inflammatory response than percutaneous nephrolithotomy in the treatment of complex upper ureteral calculi,and it can shorten the hospitalization cycle,and has less intraoperative blood loss and much safety.