钬激光碎石术联合坦洛新治疗输尿管结石的效果及对血清sVCAM-1、Cor水平的影响

Clinical efficacy of holmium laser lithotripsy combined with tamsulosin in the treatment of ureteral calculi and its effect on serum sVCAM-1 and Cor

目的探讨钬激光碎石术联合坦洛新治疗输尿管结石的效果及对血清可溶性血管细胞黏附分子-1(sVCAM-1)、皮质醇(Cor)水平的影响。方法选取2015年3月至2019年12月文昌市人民医院收治的132例输尿管结石患者,依据随机数表法将患者分成观察组和对照组,每组66例。两组患者均行钬激光碎石术,观察组患者术后服用坦洛新缓释片。记录两组患者的手术情况、临床疗效、血清sVCAM-1和Cor水平及并发症等标志物。结果两组患者的手术时间、住院时间、碎石成功率和结石排净率等比较,差异无统计学意义(P>0.05);治疗3个月后,观察组患者的总有效率明显高于对照组(100%vs.93.94%,χ^(2)=4.125,P<0.05);两组患者术前1 d和术后3个月的血清sVCAM-1和Cor水平比较,差异无统计学意义(P>0.05);观察组患者术后7 d的血清sVCAM-1和Cor水平明显低于对照组(P<0.05);两组患者总并发症发生率比较,差异无统计学意义(18.18%vs.19.70%,P>0.05)。结论钬激光碎石术联合坦洛新治疗可有效降低血清sVCAM-1和Cor浓度,提高临床疗效,值得临床进行推广。

Objective To study the effect of holmium laser lithotripsy combined with tamsulosin sustained release capsules in the treatment of ureteral calculi and its effect on serum soluble intercellular adhesion molecule-1(sVCAM-1)and cortisol(Cor).Methods From March 2015 to December 2019,132 patients with ureteral calculi treated in the people's hospital of Wenchang city were randomly divided into observation group(n=66)and control group(n=66).Patients in both groups were treated with holmium laser lithotripsy,and patients in the observation group were treated with tamsulosin sustained release capsules after operation.The operation,clinical efficacy,serum sVCAM-1 and Cor levels and complications between the two groups were recorded.Results The differences in parameters such as surgery time,hospitalization time,stone success rate and stone excrete rate were not statistically significant in the two groups(P>0.05).Three months after treatment,the total efficiency of patients in the observation group was,significantly higher than the control group(P<0.05).Differences in serum sVCAM-1 and Cor levels were not statistically significant between two groups 1 day before surgery and 3 months after surgery(P>0.05),while the levels of sVCAM-1 and Cor 7 days after surgery in the observation group were significantly lower than those in the control group(P<0.05).Complications such as ureter injury,infection,renal water and renal dysfunction were significant in both groups,with no statistically significant difference(P>0.05).Conclusions Holmium laser lithotripsy combined with tamsulosin can effectively improve the clinical efficacy and reduce the concentration of serum sVCAM-1 and Cor,which is safe and effective and worthy of further clinical study and promotion.