【摘要】 目的:研究微通道经皮肾镜取石术(MPCNL)联合金属清石鞘对上尿路结石伴同侧肾囊肿患者结石清除率、围术期血红蛋白水平及手术并发症发生率的影响。方法:83例上尿路结石伴同侧肾囊肿患者分为对照组(n=41)和研究组(n=42),对照组给予MPCNL术治疗,研究组给予MPCNL术联合金属清石鞘治疗。比较两组患者结石清除率、围术期血红蛋白水平和手术并发症发生率,并分析手术前后肾功能、氧化应激反应。结果:研究组结石清除率高于对照组(P<0.05);术后两组Hb、红细胞压积(HCT)水平均明显降低,但研究组高于对照组(P<0.05);术后两组患者肾功能指标、氧化应激反应指标水平均显著上升,但研究组低于对照组(P<0.05);两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。结论:MPCNL联合金属清石鞘应用于上尿路结石合并肾囊肿患者可提高结石清除率、减少术中Hb丢失、减轻肾功能损伤及氧化应激反应,且并不增加手术并发症的发生率。更多还原

【Abstract】 Objective:To study the effects of minimally invasive percutaneous nephrolithotomy(MPCNL) combined with metal sheath on stone clearance rate, level of perioperative hemoglobin and incidence of surgical complications in patients with upper urinary tract stones and ipsilateral renal cysts.Methods: A total of 83 patients with upper urinary tract stones and ipsilateral renal cysts were enrolled and divided into control group(41 cases, MPCNL) and study group(42 cases, MPCNL combined with metal sheath).The stone clearance rate, level of perioperative hemoglobin and incidence of surgical complications were compared between the two groups.The renal function and oxidative stress response before and after surgery were analyzed.Results: The stone clearance rate in study group was significantly higher than that in control group(P<0.05).After surgery, levels of HB and hematocrit(HCT) in both groups were significantly decreased, which were higher in study group than in control group(P<0.05).After surgery, levels of renal function indexes and oxidative stress response indexes in both groups were significantly increased, which were lower in study group than in control group(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion: The application of MPCNL combined with metal sheath in patients with upper urinary tract stones and ipsilateral renal cysts can increase stone clearance rate, reduce intraoperative loss of Hb, alleviate renal damage and oxidative stress response, without increasing incidence of surgical complications.更多还原