[1]凌 峰,薛 珺,章 钟,等.微创经皮肾镜碎石取石术小剂量地塞米松干预对肾结石疗效影响价值研究[J].陕西医学杂志,2024,(8):1077-1080.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.015]
 LING Feng,XUE Jun,ZHANG Zhong,et al.Effect of low-dose dexamethasone intervention in minimally invasive percutaneous nephrolithotomy on the efficacy of kidney stones[J].,2024,(8):1077-1080.[doi:DOI:10.3969/j.issn.1000-7377.2024.08.015]
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微创经皮肾镜碎石取石术小剂量地塞米松干预对肾结石疗效影响价值研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年8期
页码:
1077-1080
栏目:
临床研究
出版日期:
2024-08-05

文章信息/Info

Title:
Effect of low-dose dexamethasone intervention in minimally invasive percutaneous nephrolithotomy on the efficacy of kidney stones
作者:
凌 峰1薛 珺2章 钟1徐启鹏1
(1.宁国市人民医院,安徽 宁国 242300; 2.南京医科大学第二附属医院,江苏 南京 210003)
Author(s):
LING FengXUE JunZHANG ZhongXU Qipeng
(Ningguo People's Hospital,Ningguo 242300,China)
关键词:
肾结石 微创经皮肾镜碎石取石术 小剂量地塞米松 氧化应激 中性粒细胞明胶酶相关脂质运载蛋白 肾损伤分子-1 β2-微球蛋白
Keywords:
Kidney stone Minimally invasive percutaneous nephrolithotomy Low-dose dexamethasone Oxidative stress Neutrophil gelatinase-associated lipocalin Kidney injury molecule-1 β2-microglobulin
分类号:
R 692.4
DOI:
DOI:10.3969/j.issn.1000-7377.2024.08.015
文献标志码:
A
摘要:
目的:探讨微创经皮肾镜碎石取石术(MPCNL)术中小剂量地塞米松干预对肾结石疗效影响价值。方法:选取170例肾结石患者,根据随机数字表法将患者分为观察组(MPCNL术+小剂量地塞米松)和对照组(MPCNL术),各85例。比较两组手术相关指标、治疗前后血清谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、超氧化物歧化酶(SOD)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-18、C-反应蛋白(CRP)及血清中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、β2-微球蛋白(β2-MG)水平。观察术后3个月内并发症发生情况。结果:观察组住院时间、术后抗生素使用时间以及拔除肾造瘘管时间较对照组缩短(均P<0.05)。治疗后血清GSH-Px、MDA、SOD、TNF-α、IL-6、IL-18、CRP较治疗前降低,且观察组低于对照组(均P<0.05)。治疗后血清NGAL、KIM-1、β2-MG水平高于治疗前,且观察组低于对照组(均P<0.05)。对照组并发症发生率14.12%高于观察组4.71%(P<0.05)。结论:肾结石患者MPCNL术中应用小剂量地塞米松干预有助于减轻机体氧化应激和炎症反应,降低血清NGAL、KIM-1、β2-MG水平,且安全性较高。
Abstract:
Objective:To investigate the effect of low-dose dexamethasone intervention in minimally invasive percutaneous nephrolithotomy(MPCNL)on the efficacy of kidney stones.Methods:A total of 170 patients with kidney stones were selected and divided into the observation group(MPCNL+low-dose dexamethasone)and the control group(MPCNL)according to the random number table method,85 cases in each group.The operation related indicators,serum glutathione peroxidase(GSH-Px),malondialdehyde(MDA),superoxide dismutase(SOD),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),IL-18,C-reactive protein(CRP)and serum neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),β2-microglobulin(β2-MG)level before and after treatment were compared between the two groups.The occurrence of complications within 3 months after operation was observed.Results:The hospitalization time,postoperative antibiotic use time and nephrostomy tube extraction time in observation group were shorter than those in control group(all P<0.05).After treatment,serum GSH-Px,MDA,SOD,TNF-α,IL-6,IL-18 and CRP were lower than those before treatment,and the observation group was lower than the control group(all P<0.05).Serum levels of NGAL,KIM-1 and β2-MG after treatment were higher than before treatment,and lower in observation group than control group(all P<0.05).The complication rate of control group was 14.12% higher than that of observation group 4.71%(P<0.05).Conclusion:The application of low-dose dexamethasone intervention in MPCNL in patients with kidney stones can alleviate oxidative stress and inflammatory response,and reduce serum levels of NGAL,KIM-1 and β2-MG,with high safety.

参考文献/References:

[1] 雷光辉,高海捷.经皮肾镜联合输尿管软镜碎石取石术对复杂性肾结石患者结石残留率、术后恢复和生活质量的影响[J].陕西医学杂志,2020,49(5):578-580,618.
[2] 康峰,杜丽娜.两种不同术式对肾结石患者血清Cys-C、NGAL、Kim-1、凝血功能和MDA、SOD水平的影响[J].陕西医学杂志,2019,48(5):564-568.
[3] 武一鸣,罗永革.中西医结合治疗对肾结石合并RNS患者的疗效及对肾功能、炎症因子的影响[J].陕西中医,2017,38(12):1673-1675.
[4] 李逊,曾国华,吴开俊,等.微创经皮肾穿刺造瘘术治疗上尿路疾病[J].中华泌尿外科杂志,2004,25(3):169-171.
[5] NAYYAR R,SACHAN A,AGGARWAL N,et al.Anatomical approach to PCNL:Concept of ideal puncture zone in a 3D perspective[J].Urolithiasis,2023,51(1):99.
[6] 袁宏毅,肖宁.mPCNL与RIRS对>2 cm肾结石患者一期净石率、肾功能、肾血流动力学及氧化应激反应的影响[J].临床误诊误治,2023,36(3):77-82.
[7] 那彦群.中国泌尿外科疾病诊断治疗指南(2014版)[M].北京:人民卫生出版社,2014:132-133.
[8] YU R,GE J,LEI Y.Effects of different nursing modes on immune function and renal function in patients with renal calculus undergoing percutaneous nephrolithotomy[J].Arch Esp Urol,2023,76(9):703-710.
[9] PATHAK N,AGRAWAL S,PARIKH A,et al.A randomized controlled trial comparing infectious complications using mini perc with and without suction for renal stones less than 3 cm in size[J].Urolithiasis,2023,52(1):6.
[10] 徐小涵,唐贤富,郑兴明,等.三种微创术式治疗对嵌顿性输尿管上段结石患者肾功能、血清CAT、GSH-Px、MDA、ROS水平及炎症因子水平的影响[J].微创泌尿外科杂志,2019,8(2):114-118.
[11] 赵朋朋,黄剑华,徐战平.术前单次小剂量甲强龙对经皮肾镜碎石取石术后全身炎症反应综合征影响的回顾性研究[J].岭南现代临床外科,2021,21(6):658-662.
[12] 王鹏,刘军,杨波.输尿管软镜钬激光碎石术中使用地塞米松预防脓毒症效果评价[J].山西医药杂志,2019,48(8):919-921.
[13] 沈勇虎,杨增士,洪景范,等.侧卧体位微创治疗输尿管上段结石的效果及术中应用小剂量地塞米松对患者C反应蛋白和降钙素原水平的影响[J].中国医药,2019,14(3):419-422.
[14] 李晓龙,高青青,李博,等.丙泊酚全凭静脉麻醉联合乌司他丁对全麻下经皮肾镜碎石取石术围术期氧化应激、应激反应、肾功能的影响[J].现代中西医结合杂志,2019,28(8):893-897.
[15] 李成山,潘正故,刘敏,等.多发肾结石患者微创经皮肾镜取石术后感染耐药菌与药敏分析[J].中华医院感染学杂志,2019,29(2):261-264,272.
[16] 陈清霞,叶燕乐,颜景佳,等.氟比洛芬酯联合地塞米松用于PCNL手术超前镇痛及术后全身炎症反应综合征的临床研究[J].中国现代医药杂志,2019,21(5):9-12.
[17] 向近杰,李颢.细胞焦亡在草酸钙肾结石形成机制中的研究进展[J].肾脏病与透析肾移植杂志,2023,32(2):168-173.
[18] 覃天资,黄群,吴军,等.肾结石患者血尿酸水平与尿液肾损伤分子-1、NGAL、β2-MG水平的关系[J].山东医药,2019,59(21):61-64.
[19] FADALLAH M,ABDELHALIM A,HASHEM A,et al.The ideal interval between repeated shockwaves lithotripsy sessions for renal stones:A randomized controlled trial[J].J Endourol,2023,37(12):1305-1313.
[20] NOURELDIN Y A,ABDEL-HALIM W A,ELNAHIF E,et al.The effect of piezoelectric shockwave lithotripsy with 2- and 8-mm focus sizes on stone disintegration and renal injury[J].BJU Int,2023,132(4):404-410.
[21] 郑军,刘丽丽,韩晋宇,等.脓毒症合并急性肾损伤患者尿液NGAL水平与肾动脉阻力指数、APACHEⅡ评分及28 d病死率的关系[J].现代生物医学进展,2021,21(15):2897-2901.
[22] 牛忠涛,刘亚红,袁宏毅,等.尿沉渣联合尿标志物诊断肾结石经皮肾镜碎石取石术后肾损伤的临床价值研究[J].临床肾脏病杂志,2022,22(4):304-309.
[23] 穆宏鑫,杨波,成国志,等.MPCNL、FUSL和ESWL术治疗急诊上尿路结石患者的疗效对比及对KIM-1、β2-MG表达的影响[J].宁夏医学杂志,2022,44(10):939-942.
[24] 陈颖虎,冉启华,梁强,等.对比分析复杂性肾结石开放性手术与微创经皮肾镜穿刺取石术的疗效[J].解放军预防医学杂志,2020,38(11):23-25.
[25] 徐辉,谢天朋,肖日海,等.小剂量地塞米松预防经皮肾镜取石术并发全身炎症反应综合征的疗效观察[J].微创泌尿外科杂志,2018,7(6):389-392.

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备注/Memo

备注/Memo:
基金项目:江苏省自然科学基金资助项目(2020JQ-363)
更新日期/Last Update: 2024-08-08