后腹腔镜输尿管切开取石术与经输尿管镜取石术治疗老年上尿路结石患者的疗效及对炎症应激指标的影响

发布时间：2018-04-30 16:39

本文选题：后腹腔镜输尿管切开取石术 + 经输尿管镜取石术　；参考：《中国老年学杂志》2016年15期

【摘要】：目的探讨后腹腔镜输尿管切开取石术(RLU)与经输尿管镜取石术(URL)治疗老年上尿路结石患者的临床疗效及对炎症应激指标的影响。方法回顾性分析该院2013年1月至2015年12月的上尿路结石老年患者100例,按照治疗方式的不同分为观察组和对照组各50例,观察组采用RLU治疗;对照组采用URL治疗。对比两组患者手术成功率和结石取净率,以及两组患者血清炎症应激指标的变化情况。结果观察组患者手术成功率为100.00%,明显高于对照组的88.00%(P0.05);观察组结石取净率为100.00%,明显高于对照组的82.00%(P0.05);两组患者术后1、3、5 d的白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α水平明显高于术前,且观察组患者术后1、3、5 d的IL-6、TNF-α水平明显低于对照组(P0.01);两组患者术后1、3、5 d的IL-2水平明显低于术前,且观察组患者术后1、3、5 d的IL-2水平明显高于对照组(P0.01);两组患者术后1、3、5 d的内皮素(ET)-1、前列腺素(PGE)2、PGF2a水平均明显高于术前,且观察组患者术后1、3、5 d的内皮素(ET)-1、前列腺素(PG)E2、PGF2a水平明显低于对照组(P0.01)。结论 RLU治疗老年上尿路结石患者的临床疗效明显优于URL,且对患者炎症应激指标的影响也明显小于URL,手术过程对机体的不良影响相对较小,有利于术后尽早康复。
[Abstract]:Objective to investigate the clinical effect of retroperitoneal laparoscopic ureterolithotomy (RLU) and transureteroscopic ureteroscopic lithotomy (URLL) in the treatment of elderly patients with upper urinary tract calculi and its effect on inflammatory stress index. Methods from January 2013 to December 2015, 100 elderly patients with upper urinary tract calculi in our hospital were retrospectively analyzed. According to the different treatment methods, they were divided into two groups: the observation group (n = 50) and the control group (n = 50). The observation group was treated with RLU and the control group was treated with URL. The success rate of operation and the rate of stone removal were compared between the two groups, and the changes of inflammatory stress index in serum of the two groups were compared. Results the successful rate of operation in the observation group was 100.00g, which was significantly higher than that in the control group (88.00g / P 0.05), the net rate of stone removal in the observation group was 100.005, which was significantly higher than that in the control group (82.00%), and the level of IL-6 and TNF- 伪 was significantly higher in the observation group than in the control group at 1: 3 and 5 days after operation, and the level of TNF- 伪 in the observation group was significantly higher than that in the preoperative group. The level of IL-6 TNF- 伪 in the observation group was significantly lower than that in the control group on the 5th day after operation, and the IL-2 level in the two groups was significantly lower than that in the control group on the 5th day after operation. The level of IL-2 in the observation group was significantly higher than that in the control group on the 5th day after operation, and the levels of ET-1 and PGF2a in the two groups were significantly higher than those in the control group on the 1st and 5th day after operation, and the levels of ET-1 and PGE 2a were significantly higher in the observation group than those in the control group. The levels of ET-1, PGF2a and PGF2a were significantly lower in the observation group than those in the control group. Conclusion the clinical effect of RLU in the treatment of elderly patients with upper urinary tract calculi is better than that of Url, and the effect on inflammatory stress index of the patients is obviously smaller than that of URL.The adverse effect of the operation on the body is relatively small, which is beneficial to the early recovery after operation.
【作者单位】：郑州市第七人民医院;
【分类号】：R699

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