| 李 峰,陈胜龙,谢 喜,王鹏桥,李 伟.微通道与标准通道经皮肾镜碎石术对上尿路结石患者肾功能及机体氧化应激反应的影响[J].,2019,19(13):2511-2514 |
| 微通道与标准通道经皮肾镜碎石术对上尿路结石患者肾功能及机体氧化应激反应的影响 |
| Effect of Microchannel and Standard Channel Percutaneous Nephrolithotomy on Renal Function and Oxidative Stress in Patients with Upper Urinary Calculi |
| 投稿时间：2019-01-04 修订日期：2019-01-26 |
| DOI：10.13241/j.cnki.pmb.2019.13.025 |
| 中文关键词: 经皮肾镜碎石术 微通道 标准通道 上尿路结石 肾功能 氧化应激 |
| 英文关键词: Percutaneous nephrolithotomy Microchannel Standard channel Upper urinary calculi Renal function Oxidative stress |
| 基金项目:四川省教育厅科研重点项目（18ZA0165） |
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| 摘要 目的：探讨微通道与标准通道经皮肾镜碎石术（PCNL）对上尿路结石患者肾功能及机体氧化应激反应的影响。方法：选取2017年3月到2018年9月在成都医学院第一附属医院接受治疗的上尿路结石患者106例，根据随机数字表法将患者分为微通道组与标准通道组各53例，其中微通道组采用微通道PCNL进行治疗，标准通道组采用标准通道PCNL进行治疗。比较两组患者的手术时间、术中出血量、一次性结石清除率、住院时间、手术感染率。比较两组患者术前、术后1d、术后3d的血尿素氮（BUN）、血肌酐（SCr）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）、皮质醇（Cor）、肾上腺素（AD）和去甲肾上腺素（NE）。结果：微通道组的手术时间长于标准通道组，术中出血量少于标准通道组（P<0.05）。两组患者各个时间点的BUN、SCr水平比较无统计学差异（P>0.05），两组患者术后1d的BUN、SCr水平高于术前（P<0.05）。两组患者术后1d、术后3d的CRP、TNF-α、IL-6水平较术前明显升高（P<0.05）；微通道组术后3d的CRP、TNF-α、IL-6水平低于标准通道组（P<0.05）。两组患者术后1d、术后3d的Cor、AD、NE水平较术前明显升高（P<0.05）；微通道组术后1d、术后3d的Cor、AD、NE水平低于标准通道组（P<0.05）。结论：微通道PCNL与标准通道PCNL治疗上尿路结石患者具有较好的疗效，但微通道PCNL术中出血量更少，且患者的炎症反应和氧化应激程度更轻。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of microchannel and standard channel percutaneous nephrolithotripsy (PCNL) on renal function and oxidative stress in patients with upper urinary calculi. Methods: 106 patients with upper urinary calculi who were treated in First Affiliated Hospital of Chengdu Medical College from March 2017 to September 2018 were selected. According to the random number table method, the patients were randomly divided into microchannel group and standard channel group, 53 cases in each group. Microchannel group was treated with microchannel PCNL, standard channel group was treated with standard channel PCNL.The operation time, the amount of intraoperative bleeding, the clearance rate of one-time stone, the time of hospitalization and the rate of operation infection of the two groups were compared.Blood urea nitrogen (BUN), serum creatinine (SCr), C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), cortisol (Cor), adrenaline (AD), norepinephrine (NE) of the two groups were compared before and 1d, 3d after operation. Results: The operation time of the microchannel group was longer than that of the standard channel group, and the amount of intraoperative bleeding was less than that of the standard channel group (P<0.05). There was no significant difference in levels of BUN and SCr between the two groups at each time point (P>0.05), the levels of BUN and SCr of the two groups 1d after operation were higher than that before operation (P<0.05). The levels of CRP, TNF-α and IL-6 in the two groups 1d and 3d after operation were significantly higher than those before operation (P<0.05). The levels of CRP, TNF-α and IL-6 in the microchannel group 3d after operation were lower than that in the standard channel group (P<0.05). The levels of Cor, AD and NE in the two groups 1d and 3d after operation were significantly higher than those before operation (P<0.05). The levels of Cor, AD and NE in the microchannel group 1d and 3d after operation were lower than that in the standard channel group (P<0.05). Conclusion: Microchannel PCNL and standard channel PCNL have good curative effect in the treatment of upper urinary calculi. However, microchannel PCNL has less bleeding, and the patient's inflammatory response and oxidative stress are lighter. |
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