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目的研究后腹腔镜与输尿管镜技术治疗感染性输尿管上段结石者后对其肾功能及C-反应蛋白(CRP)、白介素-6(IL-6)、白细胞计数(WBC)的影响,以期为感染性输尿管上段结石的治疗提供数据依据。方法收集2014年1月-2015年12月医院经输尿管内碎石技术(URSL)及腹腔镜输尿管切开取石术(RPLU)治疗感染性输尿管上段结石患者的临床资料;采用URSL治疗124例,为URSL组,采用RPLU治疗94例,为RPLU组,对比分析两组患者的临床资料、肾功能指标、炎症指标、术后并发症及术后结石清除情况。结果两组患者手术前BUN、SCr、NGAL及CRP、IL-6、WBC对比,差异无统计学意义,URSL组患者术后NGAL水平高于同组治疗前及RPLU组同期(P<0.05),RPLU组患者术后1dCRP、IL-6水平高于同组术前及URSL组同期(P<0.05),术后7dCRP、IL-6及WBC水平低于同组术前(P<0.05);两组术后并发症比较,差异无统计学意义,两组30d治疗效果均为100.00%,差异无统计学意义。结论后腹腔镜与输尿管镜技术均可有效治疗感染性输尿管上段结石,两种术式各有利弊,应结合临床选择术式。
Objective To study the effects of retroperitoneal laparoscopy and ureteroscopy on renal function, C-reactive protein (CRP), interleukin-6 (IL-6) and white blood cell count (WBC) in patients with upper ureteral calculi, Sexual ureteral calculi provide the basis for the treatment. Methods The clinical data of patients with upper ureteral calculi treated with ureteral lithotripsy (URSL) and laparoscopic ureterolithotomy (RPLU) from January 2014 to December 2015 were collected. 124 patients treated with URSL were In the URSL group, 94 cases were treated with RPLU as RPLU group. The clinical data, renal function indexes, inflammatory indexes, postoperative complications and postoperative stone clearance were compared between the two groups. Results There was no significant difference in BUN, SCr, NGAL, CRP, IL-6 and WBC between the two groups before surgery, and the level of NGAL in URSL group was higher than that of the same group before treatment and RPLU group (P <0.05) The levels of CRP and IL-6 in the RPLU group were significantly higher than those in the preoperative and URSL groups (P <0.05), and the levels of CRP, IL-6 and WBC in the RPLU group were lower than those in the preoperative and postoperative groups (P <0.05) There was no significant difference in postoperative complication between the two groups. The therapeutic effect of 30 days was 100.00% in both groups, with no significant difference. Conclusions Both retroperitoneal laparoscopy and ureteroscopy can effectively treat the upper ureteral calculi. There are advantages and disadvantages in both types of operation, which should be combined with clinical choice.