超声气压弹道和钬激光技术用于经皮肾镜下碎石清石治疗复杂性肾结石的疗效及血清学指标比较

摘要

目的:探讨超声气压弹道和钬激光技术用于经皮肾镜下碎石清石治疗复杂性肾结石的疗效及血清学指标差异.方法:收集在本院进行手术治疗的复杂性肾结石患者78例,回顾其手术方式及检查结果,分为接受超声气压弹道术治疗的观察组34例、接受钬激光治疗的对照组44例.记录两组的Ⅰ期结石取净率;采集血清中并采用肌氨酸氧化酶法检测血清肾功能指标,采用ELISA法检测炎症因子、应激激素含量.结果:观察组的平均取石时间短于对照组(P<0.05);两组Ⅰ期结石取净率比较,差异无统计学意义(P>0.05).术后3 d,观察组血清肾功能指标Scr、BUN、CysC水平低于对照组(P<0.05);观察组血清炎症因子PCT、IL-1β、IL-22、IL-13含量低于对照组,IL-4含量高于对照组(P<0.05);观察组血清中应激激素AngⅠ、AngⅡ、Adr、NE含量低于对照组(P<0.05).结论:超声气压弹道和钬激光技术均可有效清除复杂性肾结石且超声气压弹道技术具有操作快、创伤小的优势.%Objective:To study the differences in the curative effects and serum indexes of ultrasonic pneumatic and holmium laser technology for percutaneous nephrolithotomy.Methods:A total of 78 patients with complex renal calculus who underwent surgical treatment in our hospital between May 2011 and January 2016 were collected,the operation methods and test results were reviewed,and then they were divided into the observation group (n=34) who accepted ultrasonic pneumatic treatment and the control group (n=44) who accepted holmium laser treatment.StageⅠstone clearance rate of two groups were recorded;serum was collected and sarcosine oxidase method was used to detect serum renal function indexes,and ELISA method was used to detect the levels of inflammatory factors and stress hormones.Results:The mean lithotomy time of observation group was shorter than that of control group (P<0.05);Differences in stageⅠstone clearance rate were not statistically significant between two groups of patients (P>0.05).Three days after undergoing operation,serum renal function indexes Scr,BUN and CysC levels of observation group were lower than those of control group (P<0.05);serum inflammatory factors PCT,IL-1β,IL-22 and IL-13 levels of observation group were lower than those of control group while IL-4 level was higher than that of control group (P<0.05);serum stress hormones AngⅠ,AngⅡ,Adr and NE levels of observation group were lower than those of control group (P<0.05).Conclusion:Both ultrasonic pneumatic and holmium laser technology can effectively remove complex renal calculus but ultrasonic pneumatic technology shows advantages of quicker operation and less injury.