| 摘要: |
| 目的 观察无管化经皮肾镜取石术(percutaneous nephrolithotomy, PCNL)和经尿道输尿管镜取石术(ureteroscopic lithotripsy, URL)对输尿管上段结石伴感染的疗效比较,及术前术后血清高敏C反应蛋白(high-sensitivity C-reactive protein, hs-CRP),干扰素诱导蛋白10(interferon-inducible protein 10, IP-10)和血清淀粉样蛋白A(serum amyloid A, SAA)水平的变化。方法 选择2012年1月至2014年12月在我院就诊的输尿管上段结石合并感染的患者240例,按照手术方式不同分为观察组150例和对照组90例,观察组予以无管化PCNL治疗,对照组予以URL治疗。观察两组的手术成功率,结石清除率,并发症发生率,手术时间,术后最高体温,体温恢复正常时间,尿白细胞恢复正常时间和住院时间,及两组治疗前后hs-CRP,IP-10和SAA水平的变化。结果 观察组的结石清除率和手术清除率明显高于对照组(P<0.05),而两组的并发症发生率差异无统计学意义(P>0.05)。观察组的手术时间,术后最高体温,体温恢复正常时间,尿白细胞恢复正常时间和住院时间明显短于或者低于对照组(P<0.01)。两组治疗前的hs-CRP,IP-10和SAA水平差异无统计学意义(P>0.05),治疗后均较治疗前明显降低(P<0.01),而观察组的降低水平更为明显(P<0.01)。结论 无管化PCNL治疗输尿管上段结石伴感染的疗效优于URL,具有微创,并发症少,更易于控制术后机体的炎症。 |
| 关键词: 输尿管上段结石 皮肾镜取石 高敏C反应蛋白 干扰素诱导蛋白10 血清淀粉样蛋白A |
| DOI：10.16118/j.1008-0392.2016.06.017 |
| 投稿时间：2015-11-22 |
| 基金项目: |
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| Efficacy of tubeless percutaneous nephrolithotomy in upper ureteral calculi patients with infection |
| ZHANG Ju-gen |
| (Dept. of Urology, Qingpu Institute of Urology, Zhongshan Hospital, Fudan University Shanghai Medical College, Shanghai 201700, Chian) |
| Abstract: |
| Objective To assess the efficacy of tubeless percutaneous nephrolithotomy(PCNL) and ureteroscopic lithotripsy(URL) in upper ureteral calculi patients with infection. and their impact on the serum levels of. Methods Two hundred and forty upper ureteral calculi patients with infection admitted from January 2012 to December 2014 were divided into two groups: 150 cases were treated with PCNL and 90 cases with URL. The surgical success rate, stone-free rate, incidence of complication, operative time, postoperative highest temperature, time for fever abatement, time for urine test to normal and length of hospital stay were observed, and the levels of high-sensitivity C-reactive protein(hs-CRP), interferon-inducible protein-10(IP-10) and serum amyloid A(SAA) were measured before and after treatment. Results The surgical success rate and stone-free rate were significantly higher in PCNL group than that in URL group(P<0.05), while the incidence of complication showed no significant difference between two groups(P>0.05). The operative time, postoperative highest temperature, time for fever abatement, time for urine test to normal and length of hospital stay in PCNL group were significantly shorter or lower than those in URL group(P<0.01). Before treatment, the levels of hs-CRP, IP-10 and SAA had no significant differences between two groups(P>0.05), after treatment the levels of those indicators decreased significantly in two groups(P<0.01), while the reducing levels in PCNL group were more marked(P<0.01). Conclusion Tubeless percutaneous nephrolithotomy(PCNL) is effective in treatment of upper ureteral calculi patients with infection with less invasiveness, and fewer complications. |
| Key words: ureteral calculi percutaneous nephrolithotomy high-sensitivity C-reactive protein interferon-inducible protein 10 serum amyloid A |
