Clinical analysis of flexible ureteroscopy in the treatment of upper urinary calculi in patients with diabetes
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摘要: 目的:比较糖尿病患者与非糖尿病患者上尿路结石行输尿管软镜碎石术(flexible ureteroscopic lithotripsy,FURL)的临床疗效。方法:回顾性分析2015年1月~2018年6月我院收治的采用FURL治疗的190例上尿路结石患者临床资料,其中合并糖尿病患者38例(糖尿病组),非糖尿病患者152例(非糖尿病组)。两组均行FURL,比较两组患者手术时间、结石清除率、术后并发症及住院天数等指标。结果:两组患者在年龄、性别、BMI、结石大小、结石位置、手术时间、术后结石清除率及并发症等方面比较差异均无统计学意义(P>0.05),而糖尿病组在住院时间明显高于非糖尿病组(P<0.05),结石成分分析显示糖尿病组患者尿酸结石的发生率更高(P<0.05)。结论:糖尿病合并上尿路结石患者行FURL是安全、有效的,并不会增加术后感染的风险。Abstract: Objective: To compare the clinical effects of flexible ureteroscopic lithotripsy(FURL) for upper urinary calculi between patients with diabetes and without diabetes. Method: The records of 190 patients for upper urinary calculi who underwent FURL from January 2015 to June 2018 were reviewed, 38 cases with diabetes mellituswere included in diabetes group, and other 152 patients without diabetes mellitus were included in non-diabetes group. Data including operative time, postoperative hospital stay, complications, and success of stone-free rate were analyzed and compared between two groups. Result: There was no significant difference in age, gender, body mass index, stone size, stone location, operation time, postoperative stone clearance rate, or complications between the two groups(P>0.05), while the hospital stay was significantly higher indiabetes group(P<0.05), stone component analysis showed a higher incidence of uric acid stones in the diabetes group(P<0.05).Conclusion: FURL is safe and effective in patients with diabetes complicated with upper urinary calculi, for it does not increase the risk of postoperative infection.
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Key words:
- flexible ureteroscopy /
- diabetes /
- upper urinary calculi /
- clinical effects
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[1] Weizer AZ,Auge BK,Silverstein AD,et al.Routine postoperative imaging is important after ureteroscopic stone manipulation[J].J Urol,2002,168(1):46-50.
[2] Kabeya Y,Kato K,Tomita M,et al.Associations of insulin resistance and glycemic control with the risk of kidney stones[J].Intern Med,2012,51(7):699-705.
[3] Weinberg AE,Patel CJ,Chertow GM,et al.Diabetic severity and risk of kidney stone disease[J].Eur Urol,2014,65(1):242-247.
[4] 陈星,王国民,郭剑明.代谢综合征与肾结石关系的研究进展[J].复旦学报(医学版),2013,40(6):752-756.
[5] Eisner BH,Porten SP,Bechis SK,et al.Diabetic kidney stone formers excrete more oxalate and have lower urine pH than nondiabetic stone formers[J].J Urol,2010,183(6):2244-2248.
[6] Abate N,Chandalia M,Cabo-chan AJ,et al.The metabolic syndrome and uric acid nephrolithiasis:novel features of renal manifestation of insulin resistance[J].Kidney Int,2004,65(2):386-392.
[7] 潘铁军.泌尿系结石微创手术治疗进展[J].临床泌尿外科杂志,2014,29(7):563-566.
[8] 徐宏伟,金承俊,阎俊,等.经皮肾镜取石术的研究现状及并发症防治策略[J].临床泌尿外科杂志,2014,29(2):174-177.
[9] Takazawa R,Kitayama S,Tsujii T.Successful outcome of flexible ureteroscopy with holmium laser lithotripsy for renal stones 2 cm or greater[J].Int J Urol,2012,19(3):264-267.
[10] 黄建林,廖勇,安宇,等.组合式输尿管软镜钬激光碎石术治疗2 cm以上肾结石36例疗效观察[J].实用医院临床杂志,2016,13(1):64-66.
[11] Dolan RD,Mcsorley ST,Mcmillan DC,et al.Attitudes of surgeons to the use of postoperative markers of the systemic inflammatory response following elective surgery[J].Ann Med Surg(Lond),2017,21:14-19.
[12] Watt DG,Horgan PG,Mcmillan DC.Routine clinical markers of the magnitude of the systemic inflammatory response after elective operation:a systematic review[J].Surgery,2015,157(2):362-380.
[13] Marks JB.Perioperative management of diabetes[J].Am Fam Physician,2003,67(1):93-100.
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