论文部分内容阅读
目的:探讨组合式输尿管软硬镜联合肾盂内压监测治疗输尿管上段结石的临床应用价值。方法:共选择输尿管上段结石患者70例,按照随机原则分配进入压力监测组36例与对照组各34例,均接受组合式输尿管软硬镜碎石术,分别在术前及术后第1、3、5天记录各项肾功能指标。结果:组合式输尿管软硬镜治疗输尿管上段结石可将一次性清石率从57.1%提高到88.6%(P<0.05)。术后第1天尿中性粒细胞明胶酶相关载脂蛋白(uNGAL)、尿半胱氨酸蛋白酶抑制剂(uCys-C)、尿β2微球蛋白(uβ2-MG)及尿微量白蛋白(uALb)明显升高(P<0.05),此后逐渐回落。压力监测组尿Alb、β2-MG、Cys-C及NGAL浓度在术后各时间点均低于对照组,差异有统计学意义(P<0.05)。结论:组合式输尿管软硬镜治疗输尿管上段结石可提高一次性清石率,术中监测肾盂内压力并主动干预有助于减少术后早期肾功能损害。
Objective: To investigate the clinical value of combined ureteral soft-lens combined with renal pelvis pressure monitoring in the treatment of upper ureteral calculi. Methods: A total of 70 patients with upper ureteral calculi were randomly divided into 36 cases of stress monitoring group and 34 cases of control group according to the principle of randomization. All patients underwent combined ureteral soft and hard lithotripsy, 3,5 days record various renal function indicators. Results: The combined ureteral soft-lens in the treatment of upper ureteral calculi can increase the one-time rate of clear stone from 57.1% to 88.6% (P <0.05). The urinary neutrophil gelatinase-associated apolipoprotein (uNGAL), urinary cystatin C (uCys-C), urinary β2 microglobulin (uβ2-MG) and urinary microalbuminuria uALb) was significantly higher (P <0.05), then gradually decline. Urinary Alb, β2-MG, Cys-C and NGAL concentrations in the stress monitoring group were lower than those in the control group at all time points after operation, with statistical significance (P <0.05). Conclusions: Combined ureteral calculi and soft lens in the treatment of upper ureteral calculi can increase the rate of one-time clear stone. Intraoperative renal pelvis pressure monitoring and active intervention can reduce the early postoperative renal dysfunction.