孙文龙

【摘要】 目的：研究與观察经皮肾镜钬激光碎石术对复杂性肾结石患者尿液炎症及肾损伤指标的影响。方法：选取2017年10月-2019年7月本院收治的100例复杂性肾结石患者为研究对象，将其依据治疗方式的不同分为对照组和观察组，各50例。对照组采用开放手术，观察组采用经皮肾镜钬激光碎石术。比较两组的手术时间、术中出血量、结石清除率、住院时间、术后不适感程度、手术前后的尿液炎症及肾损伤指标。结果：两组的手术时间比较，差异无统计学意义（P>0.05）;观察组的术中出血量少于对照组，结石清除率高于对照组，住院时间短于对照组，差异均有统计学意义（P<0.05）;观察组术后1、3 d的不适程度均轻于对照组，差异均有统计学意义（Z=2.899、2.769，P=0.003、0.006）。观察组术后的尿液炎症及肾损伤指标均低于对照组，差异均有统计学意义（P<0.05）。结论：经皮肾镜钬激光碎石术在复杂性肾结石患者中的应用效果较好，且对尿液炎症及肾损伤指标的影响更为积极，因此在复杂性肾结石患者中的应用价值较高。

【关键词】 经皮肾镜钬激光碎石术 复杂性肾结石 尿液炎症 肾损伤

Study on the Influence of Holmium Laser with Percutaneous Nephrolithotripsy for Urinary Inflammation and Renal Injury Indexes of Patients with Complex Renal Calculi/SUN Wenlong. //Medical Innovation of China， 2021， 18（05）： 0-028

[Abstract] Objective： To study and observe the influence of holmium laser with percutaneous nephrolithotripsy for urinary inflammation and renal injury indexes of patients with complex renal calculi. Method： A total of 100 patients with complex renal calculi from October 2017 to July 2019 were selected for the study， and they were divided into control group and observation group by the differences of treatment methods， 50 cases in each group. Open surgery was performed in the control group， and percutaneous nephrolithotripsy was performed in the observation group. The operation time， intraoperative blood loss， stone removal rates， hospitalization time， postoperative discomfort degree after the operation， urinary inflammation and renal injury indexes before and after the operation of two groups were compared. Result： There was no significant difference in the operation time between the two groups （P>0.05）; the intraoperative blood loss of the observation group was less than that of the control group， the stone clearance rate was higher than that of the control group， and the hospital stay was shorter than that of the control group， the differences were statistically significant （P<0.05）. 1 d and 3 d after surgery， the degree of discomfort in the observation group were less than those in the control group， the differences were statistically significant （Z=2.899， 2.769， P=0.003， 0.006）. The indexes of postoperative urinary inflammation and renal injury in the observation group were lower than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： The application effect of holmium laser with percutaneous nephrolithotripsy in the patients with patients with complex renal calculi is better， and the influence influence for urinary inflammation and renal injury indexes are more active， so its application value in the patients with complex renal calculi is higher.

[Key words] Holmium laser with percutaneous nephrolithotripsy Complex renal calculi Urinary inflammation Renal injury

First-authors address： Xingcheng Peoples Hospital， Xingcheng 125100， China

doi：10.3969/j.issn.1674-4985.2021.05.007

复杂性肾结石的临床治疗难度相对更大，且治疗过程对患者造成的影响也更为突出，不良影响主要为肾损伤，由此导致相关指标的异常升高，同时本类患者尿液中的炎症指标在术后一定时间内呈现显著升高的状态，且其表达水平与创伤程度及术后恢复效果密切相关，因此是本类手术患者的监测重点方面[1-2]。本研究就经皮肾镜钬激光碎石术对复杂性肾结石患者尿液炎症及肾损伤指标的影响进行观察与研究，并与传统开腹手术患者进行比较，现将结果报道如下。

1 资料与方法

1.1 一般资料 选取2017年10月-2019年7月本院收治的100例复杂性肾结石患者为研究对象，纳入标准：20～65岁;符合复杂性肾结石诊断标准。排除标准：合并泌尿系感染;肾功能不全;妊娠期及月经期女性;精神病史;伴有认知障碍。将患……