索利那新联合肾镜下EMS五代超声碎石清石术在膀胱结石腔内碎石治疗中的价值分析
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摘要
目的探讨索利那新联合肾镜下电子医疗系统(EMS)五代超声碎石术在膀胱结石治疗中的应用价值。方法回顾性研究,根据治疗方法将2015年5月至2017年3月河北省定州市人民医院就诊的130例膀胱结石患者分为两组,以单纯接受肾镜下EMS五代超声碎石术治疗者为对照组,以接受索利那新联合肾镜下EMS五代超声碎石术治疗者为联合组,每组各65例。比较两组患者手术治疗情况、术后膀胱功能恢复情况、膀胱功能改善情况和手术前后炎性因子变化情况。结果联合组患者手术时间(31. 56±11. 18) min、住院时间(8. 98±1. 15) d、术后24 h内膀胱痉挛次数(1. 19±0. 23)次/h及膀胱痉挛持续时间(0. 12±0. 08) s均低于对照组(36. 02±10. 21 min、10. 12±1. 12 d、2. 73±0. 16次/h、0. 31±0. 11 s),差异具有统计学意义(P <0. 05)。同时,入组时,两组患者间自我评价量表(OABSS)、国际前列腺症状评分(IPSS)、肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)及白细胞介素-6(IL-6)比较,差异无统计学意义(P> 0. 05),而术后3 d后,联合组OABSS评分(5. 53±1. 02分)、IPSS评分(3. 01±0. 85分)、TNF-α(15. 53±9. 05 nmol/L)、CRP(13. 19±8. 35μg/L)及IL-6(11. 81±9. 32 pg/ml)水平均低于对照组(7. 61±1. 38分、3. 93±0. 69分、22. 62±10. 22 nmol/L、20. 21±9. 12μg/L、15. 58±8. 19 pg/m),差异具有统计学意义(P <0. 05)。结论索利那新联合肾镜下EMS五代超声碎石术可有效改善膀胱结石的治疗效果及术后恢复情况。
Objective To explore the signiicance of application of fifth-generation ultrasonic lithotripsy with soniuna combined endoscopic electronic medical system( EMS) in treatment of bladder stones. Methods A retrospective study was conducted. A total of 130 patients with bladder stones in this hospital during May 2015 to March 2017 were divided into 2 groups,patients in control group were treated with fifth generation ultrasonic lithotripsy and patients in combiination group were treated with Soliea combined with subarachnoid EMS fifth geberation ultrasonic lithotripsy,65 cases in each group. The condition of operation,the recovery of bladder function,the improvement of bladder fuunction and the change of bladder function and changes of inflammatory factors before and after surgery were compared between these 2 groups. Results In combination group,tthe operating time was 31. 56 ± 11 min,hoapitalzation time was 8. 98 ± 1. 15 d,times for bladder spasm 1. 19 ± 0. 23 times/h,the duration for bladder spasm sustained 0. 12 ± 0. 08 sec,all of them were lower than those of control group( 36. 02 ± 10. 21 min,10. 12 ±1. 12 d,2. 73 ± 0. 16 times/h and 0. 31 ± 0. 11 s hospitalization time( 8. 98 ± 1. 15) d,the number of bladder spasm( 1. 19 ± 0. 23)/h and the duration of bladder spasm( 0. 12 ± 0. 08) were all within 24 hours after operation. In comparison with the control group,the difference was statistically significant( P < 0. 05). At the same time,when enrolled,the difference between these two groups of patients in self-evaluation scale( OABSS),international prostate symptom scores( IPSS),tumor necrosis factor alpha( TNF-α),C-reactive protein( CRP) and interleukin-6( IL-6),the difference was not statistically significant( P > 0. 05),and 3 days after surgery,OABASS score( 5. 53 ± 1. 02),IPSS score( 3.01 ± 0. 85),± TNF-α( 15. 53 ± 9. 05) nmol/L,CRP( 13. 19 ± 8. 35) μg/L and IL-6( 11. 81 ± 9. 32) pg/ml water in combination group were lower than those of control group( 7. 61 ± 1. 38,3. 93 ± 0. 69,22. 62 ± 10. 22 nmol/L,20. 21 ± 9. 12 μg/L,15. 58 ± 8. 19 pg/m),and the difference was statistically significant( P < 0. 05). Conclusion Solynacin combined with renal microsurgery EMS fifth-generation ultrasonic lithotripsy can effectively improve the effect of treatment and postoperative recovery of these patients.
Objective To explore the signiicance of application of fifth-generation ultrasonic lithotripsy with soniuna combined endoscopic electronic medical system( EMS) in treatment of bladder stones. Methods A retrospective study was conducted. A total of 130 patients with bladder stones in this hospital during May 2015 to March 2017 were divided into 2 groups,patients in control group were treated with fifth generation ultrasonic lithotripsy and patients in combiination group were treated with Soliea combined with subarachnoid EMS fifth geberation ultrasonic lithotripsy,65 cases in each group. The condition of operation,the recovery of bladder function,the improvement of bladder fuunction and the change of bladder function and changes of inflammatory factors before and after surgery were compared between these 2 groups. Results In combination group,tthe operating time was 31. 56 ± 11 min,hoapitalzation time was 8. 98 ± 1. 15 d,times for bladder spasm 1. 19 ± 0. 23 times/h,the duration for bladder spasm sustained 0. 12 ± 0. 08 sec,all of them were lower than those of control group( 36. 02 ± 10. 21 min,10. 12 ±1. 12 d,2. 73 ± 0. 16 times/h and 0. 31 ± 0. 11 s hospitalization time( 8. 98 ± 1. 15) d,the number of bladder spasm( 1. 19 ± 0. 23)/h and the duration of bladder spasm( 0. 12 ± 0. 08) were all within 24 hours after operation. In comparison with the control group,the difference was statistically significant( P < 0. 05). At the same time,when enrolled,the difference between these two groups of patients in self-evaluation scale( OABSS),international prostate symptom scores( IPSS),tumor necrosis factor alpha( TNF-α),C-reactive protein( CRP) and interleukin-6( IL-6),the difference was not statistically significant( P > 0. 05),and 3 days after surgery,OABASS score( 5. 53 ± 1. 02),IPSS score( 3.01 ± 0. 85),± TNF-α( 15. 53 ± 9. 05) nmol/L,CRP( 13. 19 ± 8. 35) μg/L and IL-6( 11. 81 ± 9. 32) pg/ml water in combination group were lower than those of control group( 7. 61 ± 1. 38,3. 93 ± 0. 69,22. 62 ± 10. 22 nmol/L,20. 21 ± 9. 12 μg/L,15. 58 ± 8. 19 pg/m),and the difference was statistically significant( P < 0. 05). Conclusion Solynacin combined with renal microsurgery EMS fifth-generation ultrasonic lithotripsy can effectively improve the effect of treatment and postoperative recovery of these patients.
引文
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[11]吴俊勇,王炜,李彤,等.经尿道肾镜EMS第五代超声联合气压弹道治疗复杂性膀胱结石的临床效果观察[J].中国当代医药,2014,21(32):33-35.
[12]冯超,徐月敏,谢弘,等.索利那新预防尿道重建术后膀胱痉挛的疗效分析[J].中华泌尿外科杂志,2014,35(1):58-63.
[13]郭立华,张谦,范应中,等.索利那新治疗小儿尿道下裂术后膀胱痉挛的疗效分析[J].中华泌尿外科杂志,2016,37(6):454-457.
[14]于洪波,林建中,吴宏飞,等.索利那新联合坦索罗辛治疗经尿道前列腺电切术术后膀胱过度活动症[J].现代泌尿外科杂志,2013,18(1):52-55.
[2]陈沛林,张立国,孟斌,等.尿路结石与尿路感染的相关性研究[J].中华流行病学杂志,2014,35(5):597-599.
[3]陈兴发.EAU2013版结石诊疗指南新意解读[J].现代泌尿外科杂志,2014,19(3):145-148.
[4]曾家元,杨蓉,张龙,等.185例尿路结石患者结石成分及分布特征分析[J].重庆医学,2016,45(36):5165-5167.
[5]Nawaz A,Wong TW.Quantitative characterization of chitosan in the skin by Fourier-transform infrared spectroscopic imaging and ninhydrin assay:application in transdermal sciences[J].J Microsc,2016,263(1):34-42.
[6]廖伟强,罗立旷,刘创明.合并前列腺增生症的膀胱结石的手术方式选择[J/CD].中华临床医师杂志(电子版),2014,8(12):2192-2195.
[7]周毅,王伟,姚远,等.不同微创腔内手术方式治疗膀胱结石老年患者的临床疗效比较[J].中国老年学杂志,2014,34(2):335-337.
[8]Rhee AC,Cain MP.Percutaneous cystolithotomy in the pediatric neuropathic bladder with laparoscopic trocar access:a modified approach useful for the augmented and native bladder,and continent urinary reservoir[J].J Pediatr Urol,2013,9(3):289-292.
[9]陈善苗,王诗建,刘守磊,等.经皮膀胱肾镜联合EMS治疗儿童膀胱结石[J].河南外科学杂志,2014,20(6):105.
[10]李进,成放群,吴继林,等.B超引导经皮膀胱造瘘肾镜EMS碎石治疗特殊类型膀胱结石[J].中国现代手术学杂志,2012,16(5):380-382.
[11]吴俊勇,王炜,李彤,等.经尿道肾镜EMS第五代超声联合气压弹道治疗复杂性膀胱结石的临床效果观察[J].中国当代医药,2014,21(32):33-35.
[12]冯超,徐月敏,谢弘,等.索利那新预防尿道重建术后膀胱痉挛的疗效分析[J].中华泌尿外科杂志,2014,35(1):58-63.
[13]郭立华,张谦,范应中,等.索利那新治疗小儿尿道下裂术后膀胱痉挛的疗效分析[J].中华泌尿外科杂志,2016,37(6):454-457.
[14]于洪波,林建中,吴宏飞,等.索利那新联合坦索罗辛治疗经尿道前列腺电切术术后膀胱过度活动症[J].现代泌尿外科杂志,2013,18(1):52-55.