| 安宇 黄建林 张峰 李敏 宋佳.输尿管软镜与经皮肾镜钬激光碎石术对肾结石患者肾功能的影响[J].,2015,15(35):6863-6866 |
| 输尿管软镜与经皮肾镜钬激光碎石术对肾结石患者肾功能的影响 |
| The Comparative Study of Effects of HolmiumLaser Lithotripsy Under SoftUreter Mirror and Percutaneous HolmiumLaser Lithotripsy UnderPercutaneous Nephroscope on the Renal Function in Treatment of RenalCalculi |
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| DOI： |
| 中文关键词: 输尿管软镜下钬激光碎石术 经皮肾镜下钬激光碎石术 肾结石 肾小球 |
| 英文关键词: Holmium laser lithotripsy under soft ureter mirror Percutaneous holmium laser lithotripsy under percutaneous nephroscope Renal calculi Glomerular |
| 基金项目:四川省卫生厅科研基金项目（130544） |
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| 中文摘要: |
| 目的：观察输尿管软镜下钬激光碎石术与经皮肾镜下钬激光碎石术治疗肾结石对患者肾功能影响。方法：选择本院于2012
年5 月-2015 年5 月收治的单发肾结石且结石直径均≤ 2 cm的患者180 例作为研究对象，根据配对分组法分为两组，每组90
例，A组采取输尿管软镜下钬激光碎石术治疗，B组采取经皮肾镜下钬激光碎石术治疗。分别于手术前后测定两组患者尿Kim-1
及血清NGAL、Cys-C水平，评估患者肾功能。结果：两组术前及术后6 h、12 h、24 h、72 h尿Kim-1 水平比较均无统计学差异（P>0.
05）；A 组术后48 h尿Kim-1 水平显著低于B组（P<0.05）。两组术后6 h、12 h、24 h尿Kim-1 水平均高于术前（P<0.05）。两组术后
6 h、12 h、24 h、48 h、72 h血清NGAL水平均高于术前，P<0.05。两组患者术前2 h、术后6 h血清Cys-C 水平均无显著统计学差异
（P>0.05）；术后12 h、24 h、48 h、72 h血清Cys-C 水平均A 组均高于B 组（P<0.05）。结论：输尿管软镜下钬激光碎石术与经皮肾镜
下钬激光碎石术治疗肾结石均对患者肾功能造成损伤，但输尿管软镜下钬激光碎石术对肾小球损伤更为严重，经皮肾镜下钬激
光碎石术对肾小管损伤较为严重，临床应注意。 |
| 英文摘要: |
| Objective:To observe the effects of holmium laser lithotripsy under soft ureter mirror and percutaneous holmium laser
lithotripsy under percutaneous nephroscope on the renal function in treatment of renal calculi.Methods:180 cases of patients with single
kidney stones with stone diameter equal ≤ 2 cm treated in our hospital from May 2012 to 2015 were selected as the research objects.
Then according to paired grouping method they were divided into two groups with 90 cases in each group. A group took flexible ureteroscope
holmium laser lithotripsy, B group adopted percutaneous nephrolithotomy holmium laser lithotripsy for the treatment. Then the
levels of urinary KIM-1 and serum NGAL and Cys-C were detected, and the renal function were evaluated between two groups.Results:There were no significant differences in Kim-1 level in the two groups preoperative 2 h and after operation of 12 h, 24 h, 72 h. The level
of Kim-1 after 48 h in A group was significantly lower than that in group B with statistical significance (P<0.05). The level of Kim-1 after
12 h, 24 h, 48 h in the two groups were higher than that before operation, P<0.05. The serum NGAL level postoperative 6 h, 12 h, 24 h,
48 h, 72 h were higher than that before surgery, P<0.05. There was no significant difference in serumCys-C level between the two groups
before 2 h and after operation of 6 h, P>0.05. The Cys-C level of A group after 12 h, 24 h, 48 h, 72 h was higher than that in B group,
P<0.05.Conclusion:Holmium laser lithotripsy under soft ureter mirror and percutaneous holmium laser lithotripsy under percutaneous
nephroscope can damage renal function in treatment of renal calculi, but the former damage is more serious about glomerulus while the
latter one is more easily to damage renal tubules, so it should be paid more attention in clinic. |
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