短期术前输尿管支架置入术对肾结石逆行肾内手术结局的影响

Effect of Short-Term Preoperative Ureteral Stent Implantation on the Outcome of Retrograde Nephrolithotomy

目的探究短期术前输尿管支架置入术对肾结石逆行肾内手术结局的影响。方法选择2019年8月—2022年5月济南重汽医院接受手术治疗的90例肾结石逆行肾内患者,采用随机数表法结合患者意愿将其区分为研究组(45例,接受短期术前输尿管支架置入术治疗)与对照组(45例,接受常规手术治疗),比较两组患者一般手术指标、Ⅰ期结石清除率、术前及术后肾功能指标、术前及术后炎症因子水平,比较两组患者围术期并发症发生率。结果研究组患者手术时间长于对照组,术中出血量少于对照组,术后下床时间和肾造瘘管留置时间均短于对照组,差异有统计学意义(P<0.05);研究组患者的单纯肾盂结石清除率稍低于对照组,肾盏多发结石清除率稍高于对照组,差异无统计学意义(P>0.05);术后1 d,研究组患者的血清皮质醇(Cor)、肾上腺素(AD)、去甲肾上腺素(NE)水平低于对照组,差异有统计学意义(P<0.05);术后1 d和7 d,研究组患者的白细胞介素-4(IL-4)和白细胞介素-10(IL-10)水平均低于对照组,差异有统计学意义(P<0.05);研究组患者并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论对肾结石逆行肾内患者开展短期术前输尿管支架置入术有助于加速患者术后康复进程,同时还可以改善患者术后的肾功能及炎性反应状态,降低患者围术期各类并发症的发生率。

Objective To investigate the effect of short-term preoperative ureteral stent implantation on the outcome of retrograde nephrolithotomy.Methods 90 patients with retrograde renal calculi who underwent surgical treatment in Jinan Heavy Truck Hospital from August 2019 to May 2022 were divided into the study group(n=45,receiving short-term preoperative ureteral stent implantation)and the control group(n=45,receiving conventional surgical treatment)by random number table method combined with the patient's wishes.The diff erence of renal function indexes and infl ammatory factors before and after operation,and the comparison of perioperative complications between the two groups.Results The operation time of patients in the study group was longer than that in the control group(P<0.05),the amount of intraoperative bleeding,the time to get out of bed after operation and the retention time of nephrostomy fi stula in the study group were lower than those in the control group(P<0.05).The clearance rate of the study group was slightly lower than that of the control group,and the clearance rate of multiple renal calculi was slightly higher than that of the control group,with no diff erence(P>0.05).The levels of serum cortisol(Cor),epinephrine(AD)and norepinephrine(NE)in the study group were lower than those in the control group on the 1st day after operation(P<0.05).At 1 and 7 days after operation,the levels of IL-4 and IL-10 in the study group were lower than those in the control group(P<0.05).The incidence of complications in the study group was,ower than the control group(P<0.05).Conclusion The short-term preoperative ureteral stent implantation for patients with retrograde renal calculi can accelerate the recovery process of patients after surgery,improve the clearance rate of multiple stones,and reduce the incidence of various complications of patients during the perioperative period.