经皮肾镜钬激光碎石术对复杂性肾结石患者肾功能及血清Cor、NE、ACTH水平的影响

李彦邦 董艳丽 李龙 李林斌

【摘要】目的：分析复杂性肾结石患者行经皮肾镜钬激光碎石术的临床价值。方法：选入我院于2017年9月至2018年11月期间接收的复杂性肾结石患者共计60例，以随机化分组模式均分为研究组和对照组，每组30例。研究组实施经皮肾镜钬激光碎石术处理，对照组实施肾切开取石术处理，记录两组肾功能状态和血清指标。结果：研究组手术用时、下床活动用时和术后住院用时对比存在差异性（P<0.05）；研究组和对照组术中出血量对比，组间不具有统计学意义（P>0.05）；研究组手术后24 h血清Cor、NE、ACTH水平低于对照组，组间比较存在差异性（P<0.05）；研究组术后并发症发生率低于对照组，组间对比具有差异性（P<0.05）。两组均未发生大出血等严重并发症，其中结石清除率分析，组间对比不具有统计学意义（P>0.05）。结论：经皮肾镜钬激光碎石术应用于复杂性肾结石患者中，有助于机体应激反应的下降，肾功能损伤的减轻。

【关键词】经皮肾镜钬激光碎石术；复杂性肾结石；效果分析

[中图分类号]R699.2 [文献标识码]A [文章编号]2096-5249（2021）07-0147-02

Effect of percutaneous nephrolithotomy with holmium laser on renal function and serum levels of cor， NE and ACTH in patients with complex renal calculi

LI Yan-bang， DONG Yan-li， LI Long*， LI Lin-bin （Jiuquan Second Peoples Hospital， Jiuquan Gansu 735000， China）

[Abstract] Objective： to analyze the clinical value of percutaneous nephrolithotomy with holmium laser in the treatment of complex renal calculi. Methods： a total of 60 patients with complex renal calculi in our hospital from September 2017 to November 2018 were randomly divided into study group and control group， 30 cases in each group. The study group was treated with percutaneous nephrolithotomy holmium laser lithotripsy， and the control group was treated with nephrolithotomy. Results： there were significant differences in operation time， ambulation time and postoperative hospitalization time in the study group （P<0.05）； there was no significant difference in intraoperative blood loss between the study group and the control group （P>0.05）； there was no significant difference in 24 hours after operation in the study group The levels of cor， NE and ACTH in the study group were lower than those in the control group （P<0.05）； the incidence of postoperative complications in the study group was lower than that in the control group （P<0.05）. No serious complications such as massive hemorrhage occurred in the two groups， and the stone clearance rate was not statistically significant （P>0.05）. Conclusions： the application of percutaneous nephrolithotomy with holmium laser in patients with complex renal calculi is helpful to reduce the stress response and renal function damage.

[Key words] percutaneous nephrolithotomy with holmium laser； complex renal calculi； effect analysis

腎结石是临床多发的一种泌尿系统疾病，临床发病率较高同时复发率极高。作为肾结石的高发国家[1]，我国每年肾结石新增病例比率较高，逐年提升。复杂性肾结石是其直径>2.5 cm的鹿角形[2]、多发性结石，分布较为广泛，结石数量较多，取石难度较大[3]。当前对复杂性肾结石患者多采取外科手术治疗。肾切开取石术适合结石较大或者无法从肾盂切开取石患者；经皮肾镜取石术主要通过显示屏的指导，经皮穿刺处理，临床并发症少，较为安全。针对于此，文章将进一步分析复杂性肾结石患者行经皮肾镜钬激光碎石术的有效性。

1 资料和方法

1.1基本数据 在2017年9月至2018年11月本院共计纳入复杂性肾结石患者60例，通过随机化分组模式分为研究组（n=30）和对照组（n=30）。研……