无管化微通道经皮肾镜取石术对肾结石患者的疗效及对CRP、IL-6、PCT水平的影响

目的研究无管化微通道经皮肾镜取石术对肾结石患者的疗效及对CRP、IL-6、PCT水平的影响。方法回顾性分析2015年4月至2017年4月本院收治的肾结石患者463例,按手术方式的不同分成研究组109例和对照组354例。对照组采用标准通道经皮肾镜取石术治疗,研究组予以无管化微通道经皮肾镜取石术治疗。分别比较两组结石清除率,各项手术指标水平,治疗前后血清CRP、IL-6、PCT水平,术后并发症发生情况,手术前后生活质量评分情况。结果研究组结石清除率高于对照组,但组间差异无统计学意义(P>0.05)。研究组手术时间、术中出血量、术后置管时间、住院时间均明显低于对照组(P<0.05)。术后研究组血清CRP、IL-6、PCT水平(0.92±0.31)nmol/L、(42.73±13.69)ng/L、(0.72±0.25)ng/L,均明显低于对照组的(1.33±0.40)nmol/L、(51.20±15.04)ng/L、(0.97±0.66)ng/L(P<0.05)。研究组术后并发症发生率为4.59%(5/109),明显低于对照组的18.93%(67/354)(P<0.05)。术后研究组各项SF-36评分均明显高于对照组,组间对比差异有统计学意义(P<0.05)。结论无管化微通道经皮肾镜取石术可能成为治疗肾结石的有效手段之一,对患者早日康复,减少并发症的发生以及改善预后均可能具有一定的积极促进作用。

Effect of tubeless and micro percutaneous nephrolithotomy on renal calculi and the level of CRP,IL-6,PCT in patients with renal calculi

Objective To study the effect of percutaneous nephrolithotripsy on renal calculus patients and their effects on CRP,IL-6 and PCT levels in patients with renal calculus.Methods A retrospective analysis was performed on 463 patients with renal calculi admitted to our hospital from April 2015 to April 2017.According to different surgical methods,109 patients were divided into a research group and 354 patients were divided into a control group.The control group was treated with standard channel percutaneous nephrolithotomy,and the study group was treated with percutaneous nephrolithotomy with tubeless microchannel.Before and after treatment,the level of serum CRP IL-6 PCT and postoperative complications were compared and quality of life score before and after surgery.Results The stone clearance rate in the study group was higher than the control group,but there was no significant difference between the two groups(P>0.05).The time of operation,the amount of intraoperative bleeding,the time of catheterization and the time of hospitalization in the study group was significantly lower than the control group(P<0.05).Postoperative study group of serum CRP,IL-6,PCT level(0.92±0.31)nmol/L,(42.73±13.69)ng/L,(0.72±0.25)ng/L,which were significantly lower than the control group of(1.33±0.40)nmol/L,(51.20±15.04)ng/L,(0.97±0.66)ng/L(P<0.05).The incidence of postoperative complications in the study group was 4.59%(5/109),which was significantly lower than the control group of 18.93%(67/354)(P<0.05).All SF-36 scores of the postoperative study group were significantly higher than those of the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusions No tubulized microchannel transcutaneous nephrolithotomy may be one of the effective methods for the treatment of renal calculi.It may play a positive role in the early recovery of the patients,the reduction of complications and the improvement of the prognosis.