输尿管软镜联合负压吸引鞘术后无管化对上尿路结石患者应激及炎症反应的影响

郑枫; 田文俊

doi:10.16766/j.cnki.issn.1674-4152.003465

输尿管软镜联合负压吸引鞘术后无管化对上尿路结石患者应激及炎症反应的影响

doi: 10.16766/j.cnki.issn.1674-4152.003465

郑枫^,,
田文俊

浦江县人民医院泌尿外科，浙江金华 322200

基金项目:

浙江省医药卫生科技计划项目 2023XY070

详细信息

通讯作者:
郑枫，E-mail: 464908270@qq.com

中图分类号: R691.4
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-04
- 网络出版日期: 2024-05-29

Effects of tubeless management following ureteroscopy combined with negative pressure suction sheath on stress and inflammation in patient with upper urinary tract calculi

ZHENG Feng^,,
TIAN Wenjun

Department of Urology, Pujiang People' s Hospital, Jinhua, Zhejiang 322200, China

摘要

摘要: 目的分析输尿管软镜联合负压吸引鞘术后无管化对上尿路结石患者应激及炎症反应的影响，为临床上尿路结石患者术后无管化应用提供参考依据。方法选取浦江县人民医院泌尿外科2022年7月—2023年7月收治的上尿路结石患者98例为研究对象，并以术后是否进行无管化处置将研究对象分为对照组(47例)和观察组(51例)。观察比较2组患者术后结石清除率及并发症发生情况，检测并比较2组患者应激、炎性指标水平。结果与对照组比较，无管化处置患者术后结石清除率无明显变化[95.7%(45/47) vs. 96.1%(49/51)，P＞0.05]。2组患者术前应激反应指标差异均无统计学意义(P＞0.05)，术后，观察组患者应激反应指标均低于对照组(P＜0.001)。2组患者术前炎性反应指标差异均无统计学意义(P＞0.05)，术后，观察组患者炎性反应指标均低于对照组(P＜0.001)。2组患者术后并发症发生情况比较，观察组患者较对照组术后并发症发生情况明显改善(P＜0.01)。结论输尿管软镜联合负压吸引鞘术后无管化可以减轻上尿路结石患者的应激和炎性反应，减少术后并发症，值得临床推广应用。
- 输尿管软镜 /
- 负压吸引鞘术 /
- 无管化 /
- 上尿路结石 /
- 炎症反应
Abstract: Objective This study aims to analyze the effects of tubeless management following ureteroscopy combined with negative pressure suction sheath on stress and inflammation in patients with upper urinary tract calculi, proving valuable insights for the clinical application of tubeless management in patients with urinary tract calculi. Methods A total of 98 patients with upper urinary tract calculi admitted to the Department of Urology of Pujiang People ' s Hospital from July 2022 to July 2023 were selected. They were divided into two groups based on whether tubeless treatment was performed after surgery: the control group (47 cases) and the observation group (51 cases). Stone clearance rate, complications, as well as stress and inflammatory indexes were observed, compared, and analyzed between the two groups. Results No significant difference was found in postoperative stone clearance between the patients with tubeless treatment compared to the control group [95.7% (45/47) vs. 96.1% (49/51), P>0.05]. Preoperative stress response indexes showed no significant difference between the two groups (P>0.05). However, after surgery, the patients with tubeless treatment exhibited lower stress levels compared to the control group (P < 0.001). Similarly, there was no significant difference in preoperative inflammatory response indicators between the two groups (P>0.05), but the observation group showed lower inflammation levels than the control group after surgery (P < 0.001). Furthermore, postoperative complications were compared between the two groups, and the patients with tubeless treatment demonstrated significantly improved outcomes compared to the control group (P < 0.01). Conclusion Tubeless management following ureteroscopy combined with negative pressure suction sheath can effectively alleviate the stress, inflammation, and postoperative complications in patients with upper urinary tract stones, making it a valuable clinical approach.
- Ureteroscope /
- Negative pressure suction sheath /
- Tubeless /
- Upper urinary tract calculi /
- Inflammatory response

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表 1 2组上尿路结石患者应激反应指标比较(x±s)

Table 1. Comparison of stress response indexes in two between the two groups of patients with upper urinary tract calculi(x±s)

组别	例数	Cor(μg/L)		NE(ng/L)		ACTH(pg/L)
组别	例数	术前	术后	术前	术后	术前	术后
对照组	47	121.04±21.43	246.19±34.57^b	193.39±29.23	318.42±36.82^b	26.34±5.24	54.68±9.34^b
观察组	51	122.86±22.14	201.69±30.76^b	196.11±29.35	269.96±32.19^b	26.41±5.18	43.72±8.63^b
统计量		0.413^a	1 923.513^c	0.459^a	165.348^c	0.066^a	3 218.634^c
P值		0.681	< 0.001	0.647	< 0.001	0.947	< 0.001
注：^a为t值，^c为F值。与同组术前比较，^bP＜0.05。

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表 2 2组上尿路结石患者炎性反应指标比较(x±s)

Table 2. Comparison of inflammatory response indexes in 2 between the two groups of patients with upper urinary tract calculi(x±s)

组别	例数	PCT(ng/L)		IL-6(ng/mL)		CRP(mg/L)		TNF-α(ng/mL)
组别	例数	术前	术后	术前	术后	术前	术后	术前	术后
对照组	47	0.46±0.12	1.07±0.25^b	35.61±8.34	51.23±14.43^b	9.86±2.28	21.34±3.17^b	1.41±0.22	3.55±0.43^b
观察组	51	0.44±0.13	0.82±0.21^b	35.12±8.25	44.87±13.18^b	9.78±2.15	15.96±2.85^b	1.39±0.21	2.23±0.34^b
统计量		0.789^a	3 435.610^c	0.292^a	82.256^c	0.179^a	658.847^c	0.460^a	2 035.273^c
P值		0.432	< 0.001	0.771	0.025	0.858	< 0.001	0.646	< 0.001
注：^a为t值，^b为F值。与同组术前比较，^bP＜0.05。

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