微创经皮肾镜取石术对泌尿系结石合并感染患者的临床疗效

廖鑫鑫

【摘要】 目的：探討微创经皮肾镜取石术对泌尿系结石合并感染患者的临床疗效。方法：选取2017年1月-2020年1月九江学院附属医院收治的泌尿系结石合并感染患者96例作为研究对象，采用随机数字表法分为对照组（n=48）与病例组（n=48）。对照组采用软镜钬激光碎石术治疗，病例组应采用微创经皮肾镜取石术治疗。比较两组临床疗效（手术时间、术中出血量、住院时间及结石清除率）、术后并发症及对肾功能、血清炎症因子的影响。结果：病例组手术时间、住院时间均明显短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）。病例组结石清除率为95.83%，高于对照组的83.33%，并发症发生率为6.25%，低于对照组的20.83%，差异均有统计学意义（P<0.05）。治疗前，两组血尿素氮（BUN）、血肌酐（Scr）、尿酸（UA）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）水平比较，差异均无统计学意义（P>0.05）;治疗后，两组BUN、Scr、UA、IL-6、IL-8、TNF-α、CRP水平均低于治疗前，且病例组均低于对照组，差异均有统计学意义（P<0.05）。结论：微创经皮肾镜取石术治疗泌尿系结石合并感染患者临床效果显著，有利于提高结石清除率，改善肾功能，降低炎症反应，加快术后恢复，降低并发症发生风险，对患者远期生活质量有着十分深远的影响，值得临床推广。

【关键词】 微创经皮肾镜取石术 泌尿系结石 感染 结石清除率

Clinical Effect of Minimally Invasive Percutaneous Nephrolithotomy on Patients with Urinary Calculi and Infection/LIAO Xinxin. //Medical Innovation of China， 2021， 18（35）： 0-039

[Abstract] Objective： To explore the clinical efficacy of minimally invasive nephrolithotomy on patients with urinary calculi and infection. Method： Ninety-six patients with urinary calculi and infection who admitted to the Affiliated Hospital of Jiujiang University from January 2017 to January 2020 were selected as the research objects and divided into the control group （n=48） and the case group （n=48） according to the random number table method. The control group was treated with soft mirror holmium laser lithotripsy， and the case group was treated with minimally invasive percutaneous nephrolithotomy. The clinical efficacy （operating time， intraoperative blood loss， hospitalization time and stone clearance rate）， postoperative complications， and effects on renal function and serum inflammatory factors were compared between two groups. Result： The operation time and hospital stay in the case group were significantly shorter than those in the control group， and the amount of intraoperative blood loss was less than that in the control group， the differences were statistically significant （P<0.05）. The stone clearance rate in the case group was 95.83%， which was higher than 83.33% in the control group， and the total incidence of complications was 6.25%， which was lower 20.83% of the control group， the differences were statistically significant （P<0.05）. Before treatment， the levels of blood urea nitrogen （BUN）， serum creatinine （Scr）， uric acid （UA）， interleukin-6 （IL-6）， interleukin-8 （IL-8）， tumor necrosis factor-α （TNF-α）， C-reactive protein （CRP） of two groups were compared， the differences were not statistically significant （P>0.05）; after treatment， the levels of BUN， Scr， UA， IL-6， IL-8， TNF-α， CRP of two groups were lower than those before treatment， and the case group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Minimally invasive percutaneous nephrolithotomy in the treatment of patients with urinary calculi and infection has a significant clinical effect， which is beneficial to improve stone removal rate， improve renal function， reduce inflammation， speed up postoperative recovery， reduce the risk of complications， and be beneficial to the long-term life of patients quality has a far-reaching impact and is worthy of clinical promotion.

[Key words] Minimally invasive percutaneous nephrolithotomy Urinary calculi Infection Stone clearance rate

First-author’s address： Affiliated Hospital of Jiujiang University， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.35.009

肾结石是一种较为常见的泌尿外科疾病，大部分情况下，尿结石可以出现在泌尿系统中的各个部位，如尿道、输尿管等，一旦出现肾结石并发肾脏梗阻性损伤，若不及时对其展开有效的治疗，可能会对肾脏功能产生损伤[1-2]。……