输尿管软镜在肾结石患者中的应用以及对KIM-1、NGAL等指标的影响

Application of Ureteral Soft Scope in Patients with Kidney Stones and Its Influence on KIM-1,NGAL and Other Indexes

目的探究输尿管软镜在肾结石患者中的应用以及对尿液中肾损伤分子-1(Kidney Injury Molecule 1,KIM-1)、血清中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil Gelatinase Associated Lipocalin,NGAL)等指标的影响。方法回顾性选取2022年1月-2023年11月湖北中医药大学附属公安中医医院接受治疗的200例肾结石患者的临床资料,以手术方法不同分为对照组和研究组,每组100例。对照组接受标准经皮肾镜取石术治疗,研究组接受输尿管软镜取石术治疗,比较两组临床效果。结果与术前比较,两组术后1 d的KIM-1水平均升高,差异有统计学意义(P<0.05)。术后2 d,研究组KIM-1水平为(86.21±24.31)ng/L低于对照组的(98.41±27.96)ng/L,差异有统计学意义(t=3.293,P=0.001)。术后,两组患者的NGAL水平均较术前显著升高,差异有统计学意义(P<0.05);术后1、2 d时,两组胱抑素C(Cystatin C,Cys-C)水平高于术前,术后3 d时研究组Cys-C水平高于对照组,差异有统计学意义(P<0.05)。研究组手术、住院时间、血红蛋白下降量优于对照组,差异有统计学意义(P均<0.05)。两组结石清除率比较,差异无统计学意义(P>0.05)。结论输尿管软镜取石术治疗肾结石可以明显缩短手术时长、减少住院时间、降低术后血红蛋白下降量,同时对患者产生的创伤较小。

Objective To investigate the application of ureteral soft scope in patients with kidney stones and its effect on kidney injury molecule 1(KIM-1)and serum neutrophil gelatinase associated lipocalin(NGAL).Methods Clinical data of 200 patients with kidney stones treated in Gong'an Hospital Affiliated to Hubei University of Chinese Medi-cine from January 2022 to November 2023 were retrospectively selected,and they were divided into control group and study group according to different surgical methods,with 100 cases in each group.The control group received stan-dard percutaneous nephrolithotomy and the study group received ureteral soft lithotomy.The clinical effect of the two groups was compared.Results Compared with the preoperative level,the KIM-1 level in both groups was increased 1 d after surgery,and the differences were statistically significant(P<0.05).2 d after surgery,KIM-1 level in the study group was(86.21±24.31)ng/L,lower than that in the control group[(98.41±27.96)ng/L],the difference was statisti-cally significant(t=3.293,P=0.001).After operation,NGAL level in two groups of patients was significantly higher than before operation,the difference was statistically significant(P<0.05).The level of cystatin C(Cys-C)in the two groups was higher than that before surgery 1 and 2 d after surgery,and the level of Cys-C in the observation group was higher than that in the control group 3 d after surgery,the differences were statistically significant(P<0.05).Op-eration,hospital stay and hemoglobin decline in the study group were better than those in the control group,and the differences were statistically significant(all P<0.05).There was no significant difference in stone clearance between the two groups(P>0.05).Conclusion Flexible ureteral lithotomy for kidney stones can significantly shorten the opera-tion time,reduce the length of hospital stay,reduce the postoperative hemoglobin decline,and cause less trauma to pa-tients.