摘要
目的研究经皮肾镜碎石取石术(PCNL)肾造瘘管留置对患者术后出血、炎症反应情况的影响。方法回顾性分析2017年12月~2021年12月在宁国市人民医院行PCNL的肾结石患者100例,根据患者有无留置肾造瘘管划分为对照组、观察组,各50例,对照组留置肾造瘘管,观察组未留置肾造瘘管。对比两组患者结石清除率、手术时间和住院时间,同时对比两组患者的术后出血情况、术前及术后1 d炎性因子水平变化情况。结果两组患者结石清除率、手术时间比较,差异无统计学意义(P>0.05);对照组住院时间长于观察组[(15.28±4.82)d vs.(11.68±4.56)d],差异有统计学意义(t=3.836,P<0.05);对照组和观察组术后出血发生率(8.00%vs.6.00%)、术后出血量[(221.47±42.58)ml vs.(215.68±39.74)ml]对比差异无统计学意义(t=0.703,P>0.05);术后1 d,两组患者的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)水平均高于术前,且对照组术后1 d的CRP、TNF-α、IL-6水平分别为(23.17±3.74)mg L、(11.93±2.27)pg L、(21.85±3.72)pg L,明显高于观察组(20.85±3.6)mg L、(10.75±2.11)pg L、(19.68±3.55)pg L,差异均有统计学意义(t=3.122、2.692、2.984,P<0.05)。结论在PCNL中留置或不留置肾造瘘管均能获得良好的结石清除率,但留置肾造瘘管会延长住院时间,加剧患者术后炎症反应,恢复进程较慢。
Objective To investigate the effects of percutaneous nephrolithotripsy(PCNL)onpostoperative bleeding and inflammation.Methods A retrospective analysis was performed on the clinical data of 100 patients with renal calculus who received PCNL in our hospital from December 2017 to December 2021.The patients were divided into 2 groups according to whether the patients had indwelling nephrostomy tubes,with 50 cases in each group.The control group had indwelling nephrostomy tubes,while the study group did not.Calculus clearance rate,operation time and hospital stay were compared between the two groups.Meanwhile,postoperative bleeding,changes in inflammatory factors before and on the 1st day after surgery were compared between the two groups.Results The stone clearance rate and operation time of the control group and the study group were similar,and the difference was not statistically significant(P>0.05),while the hospital stay of the control group was longer than that of the study group(P<0.05).There was no significant difference in the incidence of postoperative bleeding(8.00%vs.6.00%)and the amount of postoperative bleeding[(221.47±42.58)ml vs.(215.68±39.74)]ml between the control group and the study group(P>0.05).On the first day after surgery,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in both groups were higher than those before surgery.The levels of CRP,TNF-αand IL-6 in the control group were(23.17±3.74)mg L,(11.93±2.27)pg L and(21.85±3.72)pg L,respectively.It was significantly higher than that of the study group(20.85±3.6)mg L,(10.75±2.11)pg L,(19.68±3.55)pg L(P<0.05).Conclusion In PCNL patients with or without renal fistulas,good stone removal rate can be achieved.But the renal fistulas may prolong the hospital stay,aggravate the postoperative inflammatory reaction and slow the recovery process down.
作者
徐启鹏
章钟
凌峰
张国华
王刚
周先明
Xu Qipeng;Zhang Zhong;Ling Feng(Department of Urology,Ningguo People′s Hospital,Xuancheng 242300,China)
出处
《中华保健医学杂志》
2024年第1期86-89,共4页
Chinese Journal of Health Care and Medicine
基金
安徽省卫生健康委科研项目(AHWJ20216131)。
关键词
肾结石
经皮肾镜碎石取石术
肾造瘘管留置
术后出血
炎症反应
Kidney stone
Percutaneous nephrolithotripsy
Nephrostomy catheter indwelling
Postoperative hemorrhage
Inflammatory response
