血糖控制情况对糖尿病合并肾结石患者钬激光碎石术治疗效果的影响分析

Effect of Blood Glucose Control on Holmium Laser Lithotripsy in Diabetic Patients with Kidney Stones

目的探究血糖控制情况对糖尿病合并肾结石患者钬激光碎石术治疗效果的影响。方法回顾性选取晋江市医院(上海市第六人民医院福建医院)于2023年1—11月收治的100例糖尿病合并肾结石患者的临床资料,根据不同血糖水平分为对照组(随机血糖>10 mmol/L,糖化血红蛋白>7%)、研究组(随机血糖≤10 mmol/L,糖化血红蛋白≤7%),每组50例。两组均行钬激光碎石术治疗。对比两组术后1 h、1 d、2 d血糖水平与术前的波动值;比较两组皮质醇(Cortisol,Cor)、醛固酮(Aldosterone,ALD)及去甲肾上腺素(Norepinephrine,NE)水平;对比两组手术时间、住院总时间和并发症发生率。结果研究组术后1 h、1 d、2 d血糖波动值均低于对照组,差异有统计学意义(P均<0.001)。术后1 d,研究组Cor水平为(223.78±18.35)nmol/L,ALD水平为(25.58±2.69)ng/L,NE水平为(85.26±5.71)μg/L,均低于对照组,差异有统计学意义(t=7.349、9.202、8.974,P均<0.001)。研究组住院时间短于对照组,差异有统计学意义(P<0.001)。研究组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论糖尿病合并肾结石行钬激光碎石术患者在术前将血糖控制良好,可降低应激反应与并发症风险,从而缩短住院时间。

Objective To explore the effect of blood glucose control on holmium laser lithotripsy in diabetic patients with kidney stones.Methods The clinical data of 100 patients with diabetes mellitus complicated with renal calculi admitted to Jinjiang Hospital(Shanghai Sixth people's Hospital Fujian Hospital)from January to November 2023 were retrospectively selected.According to different blood glucose levels,they were divided into control group(random blood sugar>10 mmol/L,glycosylated haemoglobin>7%)and study group(random blood sugar≤10 mmol/L,glycosylated haemoglobin≤7%),with 50 cases in each group.Both groups were treated with holmium laser lithotripsy.The blood glucose levels at 1 h,1 d and 2 d after operation and the fluctuation values before operation were compared between the two groups.The levels of cortisol(Cor),aldosterone(ALD)and norepinephrine(NE)were compared between the two groups.The operation time,total hospitalization time and complication rate were compared between the two groups.Results The fluctuation values of blood glucose at 1 h,1 d and 2 d after operation,in the study group were lower than those in the control group,and the differences were statistically significant(all P<0.001).One day after operation,the levels of Cor,ALD and NE in the study group were(223.78±18.35)nmol/L,(25.58±2.69)ng/L and(85.26±5.71)μg/L,respectively,which were lower than those in the control group,and the differences were statistically significant(t=7.349,9.202,8.974,all P<0.001).The hospitalization time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.001).The incidence rate of complications in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion Patients with diabetes mellitus and renal calculi undergoing holmium laser lithotripsy having good blood glucose control before surgery,can reduce the risk of stress response and complications,thereby shortening the length of hospital stay.