糖尿病患者与非糖尿病患者肾结石行微创经皮肾取石术的比较

发布时间：2018-03-15 00:30

本文选题：微创经皮肾取石术　切入点：糖尿病　出处：《实用医学杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨比较糖尿病患者与非糖尿病患者肾结石行微创经皮肾取石术的临床疗效。方法:回顾性分析2007年5月至2016年6月2 796例中582例糖尿病患者肾结石(糖尿病组)在X线引导下行F18微创经皮肾取石术,年龄为26~82岁,男279例,女303例,其中肾盂结石174例,多发性结石255例,鹿角状结石153例,空腹血糖5.4~20.3 mmol/L,餐后2 h血糖9.1~28.9 mmol/L,术前均行空腹血糖、糖化血红蛋白、餐后2 h血糖、免疫糖尿病2项等检查,均符合WHO糖尿病诊断及分型标准,结石标本均行红外线光谱自动分析仪器测定结石成分。剩下的2 214例非糖尿病肾结石患者作为非糖尿病组。对两组患者的手术时间、结石取净率、手术并发症、住院天数进行评估。结果:糖尿病患者组手术时间、结石取净率、手术并发症与非糖尿病患者组差异无统计学意义(P0.05);而糖尿病患者组住院天数明显高于非糖尿病患者组(P0.05);糖尿病患者组与非糖尿病患者组的结石成分相比,尿酸结石的发病率更高,两组之间差异有统计学意义(P0.05)。结论:微创经皮肾取石术治疗糖尿病患者肾结石是安全、有效的。针对糖尿病患者具有较高形成尿酸结石的风险和血糖控制欠佳的患者结石复发率高的特点,提醒泌尿外科医师对糖尿病人群进行结石预防的重要性。
[Abstract]:Objective: to compare the clinical effect of minimally invasive percutaneous nephrolithotomy between diabetic patients and non-diabetic patients. Methods: from May 2007 to June 2nd 2016, 582 cases of diabetic nephrolithiasis were retrospectively analyzed. F18 minimally invasive percutaneous nephrolithotomy was performed under X-ray guidance. There were 279 males and 303 females, including 174 renal pelvis calculi, 255 multiple calculi, 153 staghorn calculi, fasting blood glucose 5.4 mg / L, postprandial blood glucose 9.1 mmol / L, 28.9 mmol / L postprandial blood glucose, preoperative fasting blood glucose, glycosylated hemoglobin, 2 h postprandial blood glucose, and 2 h postprandial blood glucose. The two items of immune diabetes were in accordance with the criteria of diagnosis and typing of WHO diabetes mellitus. The stone components were determined by infrared spectrum automatic analysis instrument. The remaining 2214 cases of non-diabetic renal calculi were treated as non-diabetic group. The operation time, stone removal rate, surgical complications were compared between the two groups. Results: the duration of operation, the rate of stone removal, the duration of operation and the rate of stone removal in diabetic patients were evaluated. There was no significant difference between the operative complications and the non-diabetic group (P 0.05), but the hospitalization days in the diabetic group were significantly higher than those in the non-diabetic group (P 0.05), and the stone composition in the diabetic group was significantly higher than that in the non-diabetic group. The incidence of uric acid stones was higher, and the difference between the two groups was statistically significant (P 0.05). Conclusion: minimally invasive percutaneous nephrolithotomy is safe in the treatment of renal calculi in diabetic patients. In view of the high risk of the formation of uric acid stones and the high recurrence rate of stones in patients with poor blood glucose control, urologers are reminded of the importance of urologists in the prevention of calculi in diabetics.
【作者单位】：广州医科大学附属第五医院泌尿外科广州医科大学微创外科技术和产品转化中心;中山大学附属第一医院泌尿外科;
【分类号】：R699.2;R587.1

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