输尿管镜取石时机对肾功能的影响:单中心137例患者的回顾性分析

Ahmet Semih Guleser, M. Karadağ
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摘要

目的:探讨输尿管镜下取石时机对单侧输尿管结石患者肾功能的影响。材料与方法:纳入研究的187例患者分为两组:结石诊断后≤14天接受手术的患者98例为早期手术组,结石诊断后≤14天接受手术的患者39例为晚期手术组。记录两组患者术前血清肌酐水平、血尿素氮(BUN)和肾小球滤过率(GFR)。术后1个月再次记录血清肌酐、BUN、GFR与术前比较。结果:早期手术组术前平均血清肌酐为1.25±0.65μmol/L, GFR为80.04±33.6ml/min/1.73m2, BUN为50±16.6mmol/L。术后1个月血清肌酐(0.82±0.22μmol/L, p< 0.001)、BUN(14.08±7.25mmol/L, p< 0.001)下降,GFR升高(105.33±21.6ml/min/1.73m2, p< 0.001)。术后晚期手术组血清肌酐(0.94±0.33 vs 0.95±0.30μmol/L, p= 0.102)、BUN(17.38±9 vs 17.92±8.8mmol/L, p= 0.283)均有轻微升高,GFR(95.15±27.3 vs 93.77±24.3ml/min/1.73m2, p= 0.338)均有轻微下降,差异无统计学意义。结论:我们认为最迟应在两周内进行手术治疗,因为长期梗阻可能导致肾脏损害。
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The Impact of Ureterenoscopic Stone Removal Timing on Kidney Functions: A Retrospective Analysis of 137 patients in a Single Center
Objective: To investigate the effect of ureterorenoscopic stone removal timing on kidney function in unilateral ureteral stones. Materials and Methods: Hundred and eighty-seven patients included in the study were divided into two groups: 98 patients who underwent surgery ≤14 days after the stone diagnosis constituted the Early Surgery Group and 39 patients who were operated >14 days after the stone diagnosis comprised the Late Surgery Group. Preoperative serum levels of creatinine, blood urea nitrogen (BUN), and glomerular filtration rates (GFR) were recorded for the patients in both groups. In the postoperative first month, serum creatinine, BUN, and GFR were again recorded and compared with the preoperative values. Results: The mean preoperative serum creatinine, GFR, and BUN levels in the Early Surgery Group were 1.25 ± 0.65μmol/L, 80.04 ± 33.6ml/min/1.73m2, and 50 ± 16.6mmol/L, respectively. A decrease was observed in serum creatinine (0.82 ± 0.22μmol/L, p< 0.001) and BUN (14.08 ± 7.25mmol/L, p< 0.001) levels one month after surgery, whereas GFR increased (105.33 ± 21.6ml/min/1.73m2, p< 0.001). In the Late Surgery Group, postoperative levels of serum creatinine (0.94 ± 0.33 vs. 0.95 ± 0.30μmol/L, p= 0.102), and BUN (17.38 ± 9 vs. 17.92 ± 8.8mmol/L, p= 0.283), increased minimally, also a minimal decrease was observed in GFR (95.15 ± 27.3 vs. 93.77 ± 24.3ml/min/1.73m2, p= 0.338) without any statistically significant difference. Conclusion: We believe that surgical treatment should be planned within two weeks at the latest, as prolonged obstruction may result in kidney damage.
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