摘要
目的分析糖尿病合并肾结石患者行组合式输尿管软镜碎石术(modular flexible ureteroscopic lithotripsy,M-FURL)的有效性与安全性。方法回顾性分析2013年1月至2017年10月宝鸡市中医医院收治的采用M-FURL治疗的268例肾结石患者的临床资料,将58例合并糖尿病患者纳入糖尿病组,其余210例未合并糖尿病者纳入非糖尿病组。比较两组患者的术前基线资料、结石相关资料、围术期资料及术后并发症发生情况。结果糖尿病组患者空腹血糖、餐后2小时血糖水平、草酸钙结石和尿酸结石患者占比均显著高于非糖尿病组(P<0.05),住院天数显著长于非糖尿病组(P<0.05)。两组患者性别、年龄、体质指数、结石位置、结石最大直径、结石数量、肾盂结石和鹿角形结石患者占比、手术时间、术中出血量、一次结石清除率、结石总清除率比较均无显著差异(P>0.05)。两组患者均未出现围术期死亡,呕吐、疼痛、高热、术后大量出血的发生率组间比较均无显著差异(P>0.05),经对症处理后均痊愈,患者安全出院。结论糖尿病患者更易出现肾脏草酸钙结石和尿酸结石,M-FURL在糖尿病合并肾结石患者中的有效性与安全性均较高,合并糖尿病不会影响手术效果。
Objective To analyze the efficacy and safety of modular flexible ureteroscope lithotripsy(M-FURL)in diabetic mellitus patients with renal calculi.Method Clinical data of 268 patients with renal calculi underwent M-FURL from January 2013 to October 2017 in Baoji Hospital of Traditional Chinese Medicine were analyzed retrospectively.58 cases with diabetes mellitus were included in diabetic mellitus group,and other 210 patients without diabetes mellitus were included in non-diabetic mellitus group.Preoperative baseline data,stone related data,perioperative data and postoperative complications were compared between the two groups.Result The fasting plasma glucose,2-hour postprandial blood glucose,the proportions of calcium oxalate calculus and calculus urate in diabetic mellitus group were significantly higher than those in non-diabetic mellitus group(P<0.05),the hospital stay was significantly longer than non-diabetic mellitus group(P<0.05).There were no significant differences in sex,age,body mass index,location of stones,the maximum diameter and number of stones,the proportion of renal pelvis calculus and staghorn calculus operation time,intraoperative blood loss,rate of stone clearance in one time and total clearance rate between the two groups(P>0.05).There was no perioperative death in the two groups.There were no statistically significant differences in the incidences of complications including vomiting,pain,hyperthermia and postoperative massive bleeding between the two groups(P>0.05),and these complications were cured after symptomatic treatment,then discharged safely.Conclusion Diabetic mellitus patients are more likely to appear calcium oxalate calculus and calculus urate in kidney.M-FURL is effective and safe for diabetic mellitus patients with renal calculi,and combined with diabetes mellitus does not affect the effect of operation.
作者
吕嘉
王海龙
唐黎明
LYU Jia;WANG Hai-long;TANG Li-ming(Department of Urology Surgery,Baoji Hospital of Traditional Chinese Medicine,Shaanxi,Baoji 721000,China;Department of Urology Surgery,Southern Hunan Hospital Affiliated to Hunan Normal University,Hunan,Hengyang 421002,China)
出处
《中国医学前沿杂志（电子版）》
2018年第2期65-69,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
湖南省卫生计生委2017年科研计划项目(C2017023)
关键词
组合式输尿管软镜
肾结石
糖尿病
激光碎石
Modular flexible ureteroscope
Renal calculi
Diabetes mellitus
Laser lithotripsy
