输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术影响肾盂旁囊肿患者应激反应的对比分析

郭辉; 刘川海; 孙家各; 张晓毅

doi:10.16016/j.1000-5404.202101103

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输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术影响肾盂旁囊肿患者应激反应的对比分析

临床医学 | 更新时间：2026-01-09

- 输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术影响肾盂旁囊肿患者应激反应的对比分析
- Comparison of holmium laser incision and internal drainage under flexible ureteroscope and retroperitoneal laparoscopic decompression to stress response in patients with parapelvic cyst
- 第三军医大学学报 2021年43卷第13期页码：1258-1262
- 作者机构：
  
  100088 北京，火箭军特色医学中心泌尿外科
- 作者简介：
  
  [张晓毅，E-mail: doctorzhxy88@163.comZHANG Xiaoyi, E-mail: doctorzhxy88@163.com
- 基金信息：
- DOI：10.16016/j.1000-5404.202101103
  中图分类号： R181.32;R692.7;R699.2
- 收稿：2021-01-12，
  
  修回：2021-04-28，
  
  纸质出版：2021-07-15
- 稿件说明：
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郭辉, 刘川海, 孙家各, 等. 输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术影响肾盂旁囊肿患者应激反应的对比分析[J]. 第三军医大学学报, 2021,43(13):1258-1262.

Hui GUO, Chuanhai LIU, Jiage SUN, et al. Comparison of holmium laser incision and internal drainage under flexible ureteroscope and retroperitoneal laparoscopic decompression to stress response in patients with parapelvic cyst[J]. Journal of Third Military Medical University, 2021, 43(13): 1258-1262.
郭辉, 刘川海, 孙家各, 等. 输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术影响肾盂旁囊肿患者应激反应的对比分析[J]. 第三军医大学学报, 2021,43(13):1258-1262. DOI： 10.16016/j.1000-5404.202101103.

Hui GUO, Chuanhai LIU, Jiage SUN, et al. Comparison of holmium laser incision and internal drainage under flexible ureteroscope and retroperitoneal laparoscopic decompression to stress response in patients with parapelvic cyst[J]. Journal of Third Military Medical University, 2021, 43(13): 1258-1262. DOI： 10.16016/j.1000-5404.202101103.

摘要

目的

对比输尿管软镜下钬激光切开内引流术与后腹腔镜去顶减压术对肾盂旁囊肿患者应激反应的影响。

方法

选择2015年1月至2018年1月在本院接受治疗的肾盂旁囊肿患者42例进行前瞻性研究。采用随机数字表法将患者分为两组，每组各21例。对照组采用后腹腔镜去顶减压术治疗，观察组采用输尿管软镜下钬激光切开内引流术。对比两组患者手术一般情况、氧化应激指标、应激激素指标及并发症发生情况。

结果

与对照组比较，观察组手术时间、肛门排气时间、住院时间缩短，术中出血量减少(

0.05)。两组患者术前丙二醛(malonaldehyde，MDA)、超氧化物歧化酶(superoxide dismutase，SOD)、谷胱甘肽(glutathione，GSH) 及氧化型谷胱甘肽(glutathione disulfide，GSSG)差异均无统计学意义，术后MDA及GSSG均明显下降，SOD及GSH均明显升高，且术后观察组MDA及GSSG高于对照组，SOD及GSH均低于对照组(

0.05)。术前两组患者皮质醇(cortisol，Cor)、去甲肾上腺素(noradrenaline，NE)、血管紧张素Ⅱ(angiotensin Ⅱ，AngⅡ)及多巴胺(dopamine，DA)差异均无统计学意义，术后两组Cor、NE、DA、AngⅡ均明显升高，术后观察组Cor、NE、DA、AngⅡ均明显低于对照组(

0.05)。对照组出现2例并发症，切口感染1例，体温升高1例；观察组出现1例并发症，为体温升高，两组比较差异无统计学意义。

结论

输尿管软镜下钬激光切开内引流术对肾盂旁囊肿患者氧化应激、激素应激影响较小，且不增加并发症发生率。

Abstract

Objective

To compare the effects of ureteroscopic holmium laser incision and internal drainage surgery with posterior laparoscopic decompression on the stress response of patients with parapelvic cyst.

Methods

A total of 42 patients with parapelvic cyst treated in our hospital from January 2015 to January 2018 were selected for a prospective study

and were randomly divided into 2 groups

with 21 cases in each group. The control group was treated with retroperitoneal laparoscopic decompression

while the observation group underwent ureteroscopic holmium laser incision and internal drainage surgery. The general conditions of surgery

oxidative stress indicators

stress hormone indicators and complications were compared between the 2 groups.

Results

As compared with the control group

the operation time

anal exhaust time

postoperative hospital stay were significantly shortened

and intraoperative blood loss was reduced in the observation group (

0.05). There were no significant differences in preoperative oxidative stress indicators of malonaldehyde (MDA)

superoxide dismutase (SOD)

glutathione (GSH) and glutathione disulfide (GSSG) between the 2 groups (

0.05). However

after operation

MDA and GSSG were significantly decreased while SOD and GSH increased in both groups

and the observation group had higher MDA and GSSG

but lower SOD and GSH when compared with the control group (

0.05). Likewise

preoperative stress hormone indicators of cortisol (Cor)

noradrenaline (NE)

angiotensin Ⅱ (AngⅡ) and dopamine (DA) did not differ from the 2 groups

but they were all significantly elevated in both groups after operation

and the levels in the observation group were obviously lower than those in the control group (

0.05). In addition

there were 2 cases of postoperative complications (1 incision infection and 1 increased temperature) in the control group

and 1 case (increased temperature) in the observation group

showing no significant difference.

Conclusion

Holmium laser incision and internal drainage under flexible ureteroscope has less effect on oxidative stress and hormone stress and does not increase the incidence of complications in patients with parapelvic cyst.

关键词

Keywords

references

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