上尿路结石伴肾积脓患者应用微创手术治疗的效果及对患者肾功能的影响.docVIP

上尿路结石伴肾积脓患者应用微创手术治疗的效果及对患者肾功能的影响 【摘要】日的:探讨微创手术在上尿路结石伴肾积脓患者中的临床效果及对患者 肾功能的影响。方法：选择2016年4月?2018年3月收治的上尿路结石伴肾积脓 患者84例作为对象，随机数字表分为对照组（n二42）和观察组5二42）。对照 组采用输尿管镜取石术治疗，观察组采用微通道经皮肾镜取石术治疗，手术后 3d对患者效果进行评估。采用7600型全自动生化分析仪测定两组治疗前、治疗 后3d尿素氮、血清肌酹（Scr）、24h尿蛋白（24h UP）水平；采用酶联免疫吸 附试验测定两组手术前、手术后3d超敏C反应蛋白、肿瘤坏死因子-a（TNF-a）、 白细胞介素-6 （IL-6）水平、内皮素（ET-1）水平；采用酶联免疫吸附试验（ELISA） 完成患者血清皮质醇（CORT）、儿茶酚胺（CA）、血浆谷氨酸（GLU）水平； 统计并记录两组结石清除率、感染性休克、肾周脓肿、大出血及脓毒血症发生率, 比较两组临床效果及对患者肾功能的影响。结果：观察组手术后3dBUN Scr 及24h UP水平,均低于对照组（PvO.05）；观察组手术后3dhs?CRP、TNF?a、 IL-6及ET-1水平，均低于对照组（PvO.05）；观察组手术后3d CORT、CA、GLU 水平，均低于对照组（PV0.05）；观察组与对照组手术后结石清除率差异无统计 学意义（P0.05）；观察组手术后感染性休克、肾周脓肿、大出血及脓毒血症发 生率，均低于对照组（PvO.05）。结论：微通道经皮肾镜取石术治疗上尿路结石 伴肾积脓患者中有助于改善患者肾功能水平，降低炎症因子及应激反应，术后并 发症发牛率较低，值得推广应用。 【关键词】微通道经皮肾镜取石术；上尿路结石；肾积脓；肾功能；炎症因子； 应激反应；并发症 Effect of minimally invasive surgery on upper urinary calculi with renalempyema and its effect on renal function I Abstract 1 Objective: To investigate the clinical effect of minimally invasive surgery in patients with upper urinary calculi and renal empyema and its effect on renal function. METHODS: Eighty-four patients with upper urinary calculi and renal empyema admitted from April 2016 to March 1818 were enrolled. The random number table was divided into control group （n=42） and observation group （n=42）. The control group was treated with ureteroscopic lithotripsy. The observation group was treated with microchannel percutaneous nephrolithotomy. The effect of the patients was evaluated 3 days after surgery. The 7600 automatic biochemical analyzer was used to measure the levels of urea nitrogen, serum creatinine (Scr) and 24h urine protein (24h UP) before and after treatmen匸 The enzyme-linked immunosorbent assay was used to measure the two groups before and after surgery. Hypersensitive C-reactive protein, tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6) levels, and endothelin (ET-1) levels; patient serum was completed by enzyme-linked immunosorbent assay (ELISA) Cortisol (CORT), catecholamine (CA)