输尿管镜钬激光碎石术治疗糖尿病肾盏结石的效果及对术后尿路炎症的影响

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摘要目的探讨输尿管镜钬激光碎石术治疗糖尿病肾盏结石的效果及对术后尿路炎症的影响。方法选取2021-01-01至2023-03-31武警北京总队医院收治的行输尿管镜钬激光碎石术治疗的肾盏结石患者124例,根据是否合并糖尿病分为A组62例(合并糖尿病)和B组62例(不合并糖尿病)。观察两组治疗指标及治疗前后血清、尿液中的炎症因子表达情况。结果两组手术时间[(75.6±8.7)min vs. (73.8±12.8)min]和结石清除率(80.6% vs. 82.3%)比较,差异无统计学意义;B组住院时间(4.1±0.8)d,术中出血量(12.4±3.9)ml,显著低于A组[(6.6±1.2)d、(15.2±5.8)ml],差异有统计学意义(P<0.05)。两组手术后12 h血清IL-1β、IL-6和CRP表达量显著高于手术前,且B组明显低于A组,差异有统计学意义(P<0.05)。两组手术后12 h尿液中IL-1β、IL-6和CRP表达量显著高于手术前,且B组显著低于A组,差异具有统计学意义(P<0.05)。结论合并有糖尿病的肾盏结石患者行输尿管镜钬激光碎石术后要积极抗炎治疗,避免影响手术结果。

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	王涛
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	彭启华

关键词 ：输尿管镜, 狄激光碎石术, 糖尿病肾盏结石, 尿路炎症

Abstract：Objective To investigate the effect of ureteroscopic holmium laser lithotripsy in the treatment of diabetic renal calyceal stones and its influence on postoperative inflammation of urinary tract.Methods A total of 124 patients with renal calyceal stones treated with ureteroscopic holmium laser lithotripsy admitted to Beijing Municipal Corps Hospital of Chinese People's Armed Police Force from January 2021 to March 2023 were selected and divided into group A (with diabetes, n=62) and group B (without diabetes, n=62) according to whether they were combined with diabetes. The therapeutic indexes and the expression of inflammatory factors in serum and urine before and after treatment in the two groups were observed.Results Compared with the operation time (75.6±8.7 vs. 73.8±12.8) min and stone removal rate (80.6% vs. 82.3%) of patients in the two groups, the differences were not statistically significant; however, the length of hospitalization in group B was (4.1±0.8) d, and the amount of intraoperative blood loss was (12.4±3.9) ml, which was significantly lower than that in group A [(6.6±1.2) d, (15.2±5.8) ml], and the difference was statistically significant (P<0.05). The expressions of serum IL-1β, IL-6 and CRP in the two groups at 12 h after operation were significantly higher than those before surgery, and those in group B were significantly lower than those in group A, with statistically significant (P<0.05). The expressions of IL-1β, IL-6 and CRP in urine at 12 h after surgery were significantly higher than those before surgery in both groups, and those in group B were significantly lower than those in group A, with statistically significant (P<0.05).Conclusions Active anti-inflammatory therapy should be applied to ureteroscopic holmium laser lithotripsy in patients with renal calyceal stones combined with diabetes mellitus to avoid affecting the surgical results.

Key words： ureteroscopy holmium laser lithotripsy diabetic calyceal stone urinary tract inflammation

收稿日期: 2023-08-07

ZTFLH:

R693.4

通讯作者: 彭启华,E-mail:taow_1979@163.com

作者简介: 王涛,硕士,主治医师。

引用本文:

王涛, 聂勇, 王文江, 孙振芝, 彭启华. 输尿管镜钬激光碎石术治疗糖尿病肾盏结石的效果及对术后尿路炎症的影响[J]. 武警医学, 2024, 35(2): 140-143. WANG Tao, NIE Yong, WANG Wenjiang, SUN Zhenzhi, PENG Qihua. Effect of ureteroscopic holmium laser lithotripsy in treatment of diabetic renal calyceal stones and its influence on postoperative inflammation of urinary tract. Med. J. Chin. Peop. Armed Poli. Forc., 2024, 35(2): 140-143.

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http://journal08.magtechjournal.com/Jwk_wjyx/CN/ 或 http://journal08.magtechjournal.com/Jwk_wjyx/CN/Y2024/V35/I2/140

[4]	Palermo N E, Garg R.Perioperative management of diabetes mellitus: novel approaches[J]. Curr Diab Rep, 2019,19(4):14.
[5]	Agashe S, Petak S.Cardiac autonomic neuropathy in diabetes mellitus[J]. Methodist Debakey Cardiovasc J, 2018, 14(4):251-256.
[1]	梁飞宁,黄飞,韦志林.输尿管软镜碎石术和微创经皮肾取石术治疗肾盂肾盏结石的效果[J].中外医疗,2023,42(5):67-71.
[6]	Drayton D J, Birch R J, D'Souza F C,et al. Diabetes mellitus and perioperative outcomes: a scoping review of the literature[J]. Br J Anaesth, 2022, 128(5):817-828.
[2]	宋剑锋.普外合并糖尿病患者围术期治疗的初步探讨[J].糖尿病新世界,2016,19(12):77-78.
[7]	徐辰,蒋民军,张炜,等.比较输尿管软镜与单通道微创经皮肾镜取石术治疗单侧多发肾盏结石的疗效[J].江苏医药,2022,48(2):180-182.
[3]	Xiao M Z X, Englesakis M, Perlas A.Gastric content and perioperative pulmonary aspiration in patients with diabetes mellitus: a scoping review[J]. Br J Anaesth, 2021, 127(2):224-235.
[8]	Li D F, Gao Y L, Liu H C,et al.Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis[J]. J Transl Med, 2020,18(1):106.
[4]	Palermo N E, Garg R.Perioperative management of diabetes mellitus: novel approaches[J]. Curr Diab Rep, 2019,19(4):14.
[9]	Ulvik Ø,Æsøy M S,Juliebø J P,et al.Thuliumfibre laser versus holmium:YAG for ureteroscopic lithotripsy: outcomes from a prospective randomised clinical trial[J]. Eur Urol, 2022, 82(1):73-79.
[5]	Agashe S, Petak S.Cardiac autonomic neuropathy in diabetes mellitus[J]. Methodist Debakey Cardiovasc J, 2018, 14(4):251-256.
[10]	Sierra A,Corrales M,Somani B,et al. Laser efficiency and laser safety: holmium YAG vs. thulium fiber laser[J]. J Clin Med, 2022,12(1):149.
[6]	Drayton D J, Birch R J, D'Souza F C,et al. Diabetes mellitus and perioperative outcomes: a scoping review of the literature[J]. Br J Anaesth, 2022, 128(5):817-828.
[11]	Harris W N,Cao L,Tasian G E.Comparative effectiveness of high-power holmium laser lithotripsy for pediatric patients with kidney and ureteral stones[J]. J PediatrUrol, 2022, 18(4):463.
[7]	徐辰,蒋民军,张炜,等.比较输尿管软镜与单通道微创经皮肾镜取石术治疗单侧多发肾盏结石的疗效[J].江苏医药,2022,48(2):180-182.
[12]	Kaygisiz O,Yeni S,Turan L,et al.Ureterorenoscopiclithotripsy for pediatric kidney stones using holmium:yttrium-aluminum-garnet laser devices: 15 W vs 30 W[J]. J Endourol, 2022, 36(7):916-920.
[8]	Li D F, Gao Y L, Liu H C,et al.Use of thiazide diuretics for the prevention of recurrent kidney calculi: a systematic review and meta-analysis[J]. J Transl Med, 2020,18(1):106.
[13]	Kalantari Y, Dadkhahfar S, Etesami I. Post-acne erythema treatment: a systematic review of the literature[J]. J Cosmet Dermatol, 2022, 21(4):1379-1392.
[9]	Ulvik Ø,Æsøy M S,Juliebø J P,et al.Thuliumfibre laser versus holmium:YAG for ureteroscopic lithotripsy: outcomes from a prospective randomised clinical trial[J]. Eur Urol, 2022, 82(1):73-79.
[10]	Sierra A,Corrales M,Somani B,et al. Laser efficiency and laser safety: holmium YAG vs. thulium fiber laser[J]. J Clin Med, 2022,12(1):149.
[14]	Burhans M S, Hagman D K, Kuzma J N,et al.Contribution of adipose tissue inflammation to the development of type 2 diabetes mellitus[J]. ComprPhysiol, 2018, 9(1):1-58.
[11]	Harris W N,Cao L,Tasian G E.Comparative effectiveness of high-power holmium laser lithotripsy for pediatric patients with kidney and ureteral stones[J]. J PediatrUrol, 2022, 18(4):463.
[15]	Debédat J, Amouyal C, Aron W J,et al.Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome[J]. Semin Immunopathol, 2019, 41(4):461-475.
[12]	Kaygisiz O,Yeni S,Turan L,et al.Ureterorenoscopiclithotripsy for pediatric kidney stones using holmium:yttrium-aluminum-garnet laser devices: 15 W vs 30 W[J]. J Endourol, 2022, 36(7):916-920.
[16]	王海滨,石新慧,刘英丽.血清Klotho水平与氧化应激指标与糖尿病肾病患者肾功能的相关性分析[J].分子诊断与治疗杂志,2023,15(6):1060-1063.
[17]	金思妤.高糖高脂微环境中NFKB1基因突变对内皮细胞损伤的分子机制研究[D].乌鲁木齐:新疆医科大学,2020.
[13]	Kalantari Y, Dadkhahfar S, Etesami I. Post-acne erythema treatment: a systematic review of the literature[J]. J Cosmet Dermatol, 2022, 21(4):1379-1392.
[18]	孙芙林,岳涛,刘海燕,等.小豆蔻素调节Nrf2/HO-1/NF-κB信号通路对妊娠糖尿病大鼠氧化应激损伤的影响[J].中国优生与遗传杂志,2023,31(2):269-274.
[14]	Burhans M S, Hagman D K, Kuzma J N,et al.Contribution of adipose tissue inflammation to the development of type 2 diabetes mellitus[J]. ComprPhysiol, 2018, 9(1):1-58.
[19]	赵晶.高糖刺激的巨噬细胞源外泌体通过影响miR-7002-5p/Atg9b通路调节肾小管上皮细胞自噬[D].合肥: 安徽医科大学,2022.
[15]	Debédat J, Amouyal C, Aron W J,et al.Impact of bariatric surgery on type 2 diabetes: contribution of inflammation and gut microbiome[J]. Semin Immunopathol, 2019, 41(4):461-475.
[20]	闫磊,蒋海彬,娜菲莎·帕尔哈提,等.不同剂量右美托咪定对冠心病患者非心脏手术应激及术后睡眠影响[J].中国临床药理学与治疗学,2022,27(12):1340-1346.
[16]	王海滨,石新慧,刘英丽.血清Klotho水平与氧化应激指标与糖尿病肾病患者肾功能的相关性分析[J].分子诊断与治疗杂志,2023,15(6):1060-1063.
[21]	李佩军,张兴,邓菲,等.三种不同手术对老年大鼠术后认知功能的影响[J].世界最新医学信息文摘,2018,18(28):33-34.
[17]	金思妤.高糖高脂微环境中NFKB1基因突变对内皮细胞损伤的分子机制研究[D].乌鲁木齐:新疆医科大学,2020.
[22]	杨丽霞,李旦,杨可为,等.输尿管镜碎石术后血清炎症因子动态变化对尿源性感染的预测价值[J].中华医院感染学杂志,2023,33(5):738-742.
[18]	孙芙林,岳涛,刘海燕,等.小豆蔻素调节Nrf2/HO-1/NF-κB信号通路对妊娠糖尿病大鼠氧化应激损伤的影响[J].中国优生与遗传杂志,2023,31(2):269-274.
[23]	朱通,刘旭东,何俊,等.输尿管镜下钬激光碎石治疗对复杂性输尿管结石合并肾盂积水患者炎症指标的影响[J].微创泌尿外科杂志,2020,9(2):96-100.
[19]	赵晶.高糖刺激的巨噬细胞源外泌体通过影响miR-7002-5p/Atg9b通路调节肾小管上皮细胞自噬[D].合肥: 安徽医科大学,2022.
[24]	洪钧晖,徐思维,黄国忠,等.输尿管镜术前预测全身炎症介质反应综合征数学建模的作用[J].浙江创伤外科,2019,24(4):712-713.
[20]	闫磊,蒋海彬,娜菲莎·帕尔哈提,等.不同剂量右美托咪定对冠心病患者非心脏手术应激及术后睡眠影响[J].中国临床药理学与治疗学,2022,27(12):1340-1346.
[25]	罗立旷,湛海伦,廖伟强,等.术前尿白细胞计数及中段尿培养与输尿管镜术后全身炎症反应综合征的关系[J].中华腔镜泌尿外科杂志(电子版),2016,10(2):117-12.
[21]	李佩军,张兴,邓菲,等.三种不同手术对老年大鼠术后认知功能的影响[J].世界最新医学信息文摘,2018,18(28):33-34.
[22]	杨丽霞,李旦,杨可为,等.输尿管镜碎石术后血清炎症因子动态变化对尿源性感染的预测价值[J].中华医院感染学杂志,2023,33(5):738-742.
[23]	朱通,刘旭东,何俊,等.输尿管镜下钬激光碎石治疗对复杂性输尿管结石合并肾盂积水患者炎症指标的影响[J].微创泌尿外科杂志,2020,9(2):96-100.
[24]	洪钧晖,徐思维,黄国忠,等.输尿管镜术前预测全身炎症介质反应综合征数学建模的作用[J].浙江创伤外科,2019,24(4):712-713.
[25]	罗立旷,湛海伦,廖伟强,等.术前尿白细胞计数及中段尿培养与输尿管镜术后全身炎症反应综合征的关系[J].中华腔镜泌尿外科杂志(电子版),2016,10(2):117-12.