中国医学装备
中國醫學裝備
중국의학장비
China Medical Equipment
2015年
10期
100-102,103
,共4页
肾结石%输尿管软镜%体外冲击波碎石%上尿路结石经皮肾镜技术
腎結石%輸尿管軟鏡%體外遲擊波碎石%上尿路結石經皮腎鏡技術
신결석%수뇨관연경%체외충격파쇄석%상뇨로결석경피신경기술
Renal calculus%Flexible ureteroscope%Extracorporeal shock wave lithotripsy%Percutaneous nephrostolitho tomy
目的：研究讨论输尿管软镜联合体外冲击波碎石在2 cm以上肾结石治疗的安全性及应用价值。方法：将确诊肾结石的80例患者(结石直径均＞2 cm)，随机分为输尿管软镜碎石术(URL)组和上尿路结石经皮肾镜技术(PCNL)组，每组40例。观察比较两组手术疗效、手术时间、术后住院天数及并发症发生情况，比较两组术前及术后3d血中性粒细胞明胶酶相关载脂蛋白(NGAL)浓度水平以及肾损伤分子1(Kim-1)浓度水平变化。结果：URL组与PCNL组相比， URL组的手术疗效、手术时间及并发症均无明显差异，URL组住院天数较PCNL组少，差异具有统计学意义(t=8.433，P＜0.05)；PCNL组NGAL和Kim-1浓度水平术后1 d明显高于术前，差异有统计学意义(t=2.355，t=2.803；P＜0.05)，术后2 d与术前相比，差异无统计学意义；而URL组术后1 dNGAL明显高于术前，差异有统计学意义(t=3.319，P＜0.05)，术后2 d与术前相比，差异无统计学意义。结论：输尿管软镜联合体外冲击波碎石对于直径＞2 cm单发肾结石的疗效肯定，且并发症发生率更低，故在条件允许情况下，可作为临床推荐选择术式。
目的：研究討論輸尿管軟鏡聯閤體外遲擊波碎石在2 cm以上腎結石治療的安全性及應用價值。方法：將確診腎結石的80例患者(結石直徑均＞2 cm)，隨機分為輸尿管軟鏡碎石術(URL)組和上尿路結石經皮腎鏡技術(PCNL)組，每組40例。觀察比較兩組手術療效、手術時間、術後住院天數及併髮癥髮生情況，比較兩組術前及術後3d血中性粒細胞明膠酶相關載脂蛋白(NGAL)濃度水平以及腎損傷分子1(Kim-1)濃度水平變化。結果：URL組與PCNL組相比， URL組的手術療效、手術時間及併髮癥均無明顯差異，URL組住院天數較PCNL組少，差異具有統計學意義(t=8.433，P＜0.05)；PCNL組NGAL和Kim-1濃度水平術後1 d明顯高于術前，差異有統計學意義(t=2.355，t=2.803；P＜0.05)，術後2 d與術前相比，差異無統計學意義；而URL組術後1 dNGAL明顯高于術前，差異有統計學意義(t=3.319，P＜0.05)，術後2 d與術前相比，差異無統計學意義。結論：輸尿管軟鏡聯閤體外遲擊波碎石對于直徑＞2 cm單髮腎結石的療效肯定，且併髮癥髮生率更低，故在條件允許情況下，可作為臨床推薦選擇術式。
목적：연구토론수뇨관연경연합체외충격파쇄석재2 cm이상신결석치료적안전성급응용개치。방법：장학진신결석적80례환자(결석직경균＞2 cm)，수궤분위수뇨관연경쇄석술(URL)조화상뇨로결석경피신경기술(PCNL)조，매조40례。관찰비교량조수술료효、수술시간、술후주원천수급병발증발생정황，비교량조술전급술후3d혈중성립세포명효매상관재지단백(NGAL)농도수평이급신손상분자1(Kim-1)농도수평변화。결과：URL조여PCNL조상비， URL조적수술료효、수술시간급병발증균무명현차이，URL조주원천수교PCNL조소，차이구유통계학의의(t=8.433，P＜0.05)；PCNL조NGAL화Kim-1농도수평술후1 d명현고우술전，차이유통계학의의(t=2.355，t=2.803；P＜0.05)，술후2 d여술전상비，차이무통계학의의；이URL조술후1 dNGAL명현고우술전，차이유통계학의의(t=3.319，P＜0.05)，술후2 d여술전상비，차이무통계학의의。결론：수뇨관연경연합체외충격파쇄석대우직경＞2 cm단발신결석적료효긍정，차병발증발생솔경저，고재조건윤허정황하，가작위림상추천선택술식。
Objective:To observe the reliability and clinical implement of flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm. Methods:The diagnosed 80 cases of kidney stones (all with a diameter of more than 2cm) patients in our hospital were chosen, randomly divided into two groups, URL group and PCNL group,each of them with 40 cases. Surgical curative effect, operation time, postoperative complications, hospitalization days and the change of NGAL levels and the change of urine levels Kim-1 preoperative and postoperative blood 3 days of two groups were observed and compared. Results: Comparing with the PCNL group, the surgical curative effect, operation time and postoperative complications of the URL group have no significant difference, but the hospitalization days between are significantly different(t=8.433, P<0.05);In terms of NGAL, Kim-1, the postoperative 1d of PCNL group is significantly higher than preoperative, NGAL postoperative 1d of URL group is significantly higher than preoperative (t=3.319, P<0.05). Conclusion:It was reliable that flexible ureteroscope combined with extracorporeal shock wave lithotripsy to treat the kidney stones with a diameter of more than 2cm, lower complication rate, worthy of clinical.
