实用老年医学

实用老年医学 ›› 2022, Vol. 36 ›› Issue (6): 584-587.doi: 10.3969/j.issn.1003-9198.2022.06.009

• 临床研究 • 上一篇    下一篇

软性输尿管镜钬激光碎石术联合排石颗粒治疗老年上尿路结石病人的临床效果

刘晨溪, 曹蕾, 卢新喆, 赵红娟, 徐洋涛, 潘岩, 赵国斌   

  1. 072750 河北省保定市,保定市第二中心医院泌尿外科(刘晨溪,曹蕾,卢新喆,赵红娟,徐洋涛);肿瘤科(潘岩);
    075000 河北省张家口市,河北北方学院附属第一医院泌尿外科(赵国斌)
  • 收稿日期:2021-08-13 出版日期:2022-06-20 发布日期:2022-06-30
  • 基金资助:
    河北省医学科学研究重点课题计划(20180839)

Clinical effect of flexible ureteroscopy and lasertripsy combined with Paishi Granule in the treatment of elderly patients with upper urinary tract calculi

LIU Chen-xi, CAO Lei, LU Xin-zhe, ZHAO Hong-juan, XU Yang-tao, PAN Yan, ZHAO Guo-bin   

  1. LIU Chen-xi, CAO Lei, LU Xin-zhe, ZHAO Hong-juan, XU Yang-tao. Department of Urology; PAN Yan. Department of Oncology, Baoding Second Central Hospital, Baoding 072750, China;
    ZHAO Guo-bin. Department of Urology, the First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
  • Received:2021-08-13 Online:2022-06-20 Published:2022-06-30

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摘要： 目的 研究软性输尿管镜钬激光碎石术(FURSL)联合排石颗粒对直径2~4 cm上尿路结石老年病人的炎性因子、降钙素(PCT)水平及APACHEⅡ评分的影响。 方法 以在我院进行诊断并治疗的120例老年上尿路结石病人作为研究对象,按照随机数字表,将病人随机分为观察组及对照组,每组60例。2组均采用FURSL治疗,观察组病人在此基础上联合排石颗粒治疗,比较2组病人间结石清除率、炎性因子水平、血清PCT水平、APACHEⅡ评分以及并发症的差异。 结果 观察组病人的结石清除率显著高于对照组(91.67%比78.33%,P=0.041)。经过治疗后,2组病人的CRP、PCT、IL-1β、TNF-α、IL-6水平及APACHEⅡ评分均显著下降,且观察组病人上述指标水平均显著低于对照组,差异均有统计学意义(P＜0.01)。2组高淀粉酶血症、胰腺炎及穿孔的发生率差异均无统计学意义(P＞0.05)。 结论 直径2~4 cm老年上尿路结石病人采用FURSL联合排石颗粒治疗,病人的炎性因子、PCT水平及APACHEⅡ评分均显著下降,安全性较好,治疗效果显著,建议临床推广。

关键词: 软性输尿管镜钬激光碎石术, 上尿路结石, 排石颗粒, 炎症因子, 结石清除率

Abstract: Objective To investigate the effect of flexible ureteroscopy and lasertripsy (FURSL) combined with Paishi Granule on the levels of inflammatory factors, procalcitonin (PCT) and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the elderly patients with upper urinary tract stones with a diameter of 2-4 cm. Methods A total of 120 elderly patients with upper urinary tract calculi who were diagnosed and treated in our hospital were selected. According to random number table, the patients were divided into observation group and control group, with 60 cases in each group. All the patients underwent FURSL, and the observation group was treated with Paishi Granule additionally. The rate of calculi clearance, the levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6 and PCT, the score of APACHE Ⅱ, and the complications were compared between the two groups. Results The stone free rate in the observation group was significantly higher than that in the control group (91.67% vs 78.33%, P=0.041). After treatment, the levels of CRP, PCT, IL-1β, TNF-α and IL-6 and the score of APACHE Ⅱ in both groups were decreased significantly, especially in the observation group (P<0.01). There were no significant differences in the incidence rates of hyperamylasemia, pancreatitis and enterobrosis between the two groups (P>0.05). Conclusions FURSL combined with Paishi Granules in the treatment of the elderly patients with upper urinary tract calculi with a diameter of 2-4 cm is safe and effective. The levels of inflammatory factors and PCT, and the score of APACHE Ⅱ in the patients can be significantly decreased, which is recommended to be popularized in clinic.

Key words: flexible ureteroscopy and lasertripsy, upper urinary tract calculi, Paishi Granule, inflammatory factor, stone free rate

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