URL术式治疗肾结石患者的临床疗效及对肾损伤因子、凝血功能及氧化应激产物的影响

Clinical Efficacy of URL in the Treatment of Patients with Renal Calculi and its Effects on Renal Injury Factors, Coagulation Function and Oxidative Stress Products

目的 研究URL术式治疗肾结石患者的临床疗效及对肾损伤因子、凝血功能及氧化应激产物的影响。方法 选取2022年1月-12月安福县中医院治疗85例肾结石患者为研究对象,采用随机数字表法分为对照组(n=42)和观察组(n=43),对照组采用经皮肾镜手术治疗,观察组采用经输尿管软镜手术(URL)治疗,比较两组临床疗效、肾损伤因子[肌酐(Scr)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、半胱氨酸蛋白酶抑制剂C(CysC)]、凝血功能指标[凝血反应时间(R值)、血凝块形成的时间(K值)、最大宽度值(MA值)]、氧化应激产物[超氧化物歧化酶(SOD)、丙二醛(MDA)]及并发症发生率。结果 观察组临床治疗总有效率为93.01%,与对照组的90.48%比较,差异无统计学意义(P>0.05);两组术后NGAL、CysC、Scr均高于术前,但观察组NGAL低于对照组,CysC高于对照组(P<0.05),而两组术后Scr比较,差异无统计学意义(P>0.05);两组术后R值、K值低于术前,MA值高于术前,但观察组R值、K值高于对照组(P<0.05),而两组术后MA值比较,差异无统计学意义(P>0.05);两组术后SOD低于术前,MDA高于术前,但观察组SOD高于对照组,MDA低于对照组(P<0.05);观察组并发症发生率与对照组比较,差异无统计学意义(P>0.05)。结论 URL治疗肾结石可实现与经皮肾镜手术治疗相似的临床疗效,且可减小对肾功能、氧化应激及凝血功能的影响,可作为临床治疗肾结石的首选手术方法。

Objective To study the clinical efficacy of URL in the treatment of patients with renal calculi and its effects on renal injury factors,coagulation function and oxidative stress products.Methods A total of 85 patients with renal calculi treated in Anfu County Hospital of Traditional Chinese Medicine from January to December 2022 were selected as the research objects.They were divided into control group(n=42)and observation group(n=43)by random number table method.The control group was treated with percutaneous nephrolithotomy,and the observation group was treated with flexible ureteroscopy(URL).The clinical efficacy,renal injury factors[creatinine(Scr),neutrophil gelatinase-associated lipocalin(NGAL),cysteine protease inhibitor C(CysC)],coagulation function indexes[coagulation reaction time(R value),blood clot formation time(K value),maximum width value(MA value)],oxidative stress products[superoxide dismutase(SOD),malondialdehyde(MDA)]and complication rate were compared between the two groups.Results The total effective rate of clinical treatment in the observation group was 93.01%,which was compared with 90.48%in the control group,the difference was not statistically significant(P>0.05).NGAL,CysC and Scr in the two groups after operation were higher than those before operation,but NGAL in the observation group was lower than that in the control group,and CysC was higher than that in the control group(P<0.05),while there was no significant difference in Scr index between the two groups(P>0.05).The R value and K value of the two groups after operation were lower than those before operation,and the MA value was higher than that before operation,but the R value and K value of the observation group were higher than those of the control group(P<0.05),while there was no significant difference in MA value between the two groups(P>0.05).The SOD of the two groups after operation was lower than that before operation,and the MDA was higher than that before operation,but the SOD of the observation group was higher than that of the control group,and the MDA was lower than that of the control group(P<0.05).Conclusion URL can achieve similar clinical efficacy as percutaneous nephrolithotomy in the treatment of renal calculi,and can reduce the effects on renal function,oxidative stress and coagulation function.It can be used as the first choice for clinical treatment of renal calculi.