[经皮肾镜碎石术后 NGAL 对确定肾脏功能状态的诊断价值]。

Q4 Medicine Urologiia Pub Date : 2024-09-01
S Merinov D, A Golovanov S, Sh Gurbanov Sh, V Artemov A, K Shamkhalova K
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引用次数: 0

摘要

导言:经皮肾镜取石术(PNL)是一种微创手术,会对血管和肾实质造成损伤,从而导致肾血流动力学受损。在这项工作中,我们确定了急性肾损伤生物标志物 NGAL 的动态变化,这取决于同侧肾功能的缺失、结石的类型、通路的数量、手术的持续时间以及 NGAL 的初始水平:研究共纳入 46 名患者,分别在 PNL 之前、之后以及 6、12、24 和 48 小时后测定其血清中的 NGAL 浓度。PNL 在气管内麻醉下进行,患者取俯卧位,使用标准技术和 24 Fr 肾镜。在建立额外(不止一个)通路时,使用了带有 16.5 Fr 通路鞘的肾镜:结果:我们的研究结果表明,肾实质的功能状态在更大程度上取决于核素闪烁成像显示的初始肾功能缺损超过 50%,并伴有 3-4 种类型的鹿角状结石,而在较小程度上取决于手术的持续时间、通路的数量以及是否存在细菌尿:结论:NGAL浓度的测定是一种方便的检测方法,可用于评估PNL术后早期肾实质功能的受损和恢复情况。
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[Diagnostic value of the NGAL in determining the functional state of the kidney after percutaneous nephrolithotomy].

Introduction: Percutaneous nephrolithotomy (PNL), being a minimally invasive procedure, is accompanied by damage to blood vessels and renal parenchyma and, as a consequence, impaired renal hemodynamics. In this work we determined the dynamics of the biomarker of acute kidney injury NGAL depending on the deficit of renal function on the ipsilateral side, the type of stone, the number of accesses, the duration of the procedure, and the initial level of NGAL.

Aim: To study the role of NGAL in determining the potential risks of renal parenchyma damage with PNL in adult patients with nephrolithiasis.

Materials and methods: A total of 46 patients in whom the serum concentration of NGAL was determined before and immediately after PNL, as well as 6, 12, 24 and 48 hours later, were included in the study. PNL was performed under endotracheal anesthesia in the prone position using the standard technique with a 24 Fr nephroscope. When creating an additional (more than one) access, a nephroscope with a 16.5 Fr access sheath was used.

Results: Our results showed that the functional state of the renal parenchyma depended to a greater extent on the initial deficit of more than 50% according to nuclear scintigraphy with staghorn stones of 3-4 types, and to a lesser extent on the duration of the procedures, the number of accesses and the presence of bacteriuria.

Conclusion: Determination of NGAL concentration can be a convenient test for assessing the impairment and restoration of the functional state of the renal parenchyma in the early stages after PNL.

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来源期刊
Urologiia
Urologiia Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
160
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