首页|超声引导下经皮肾穿刺造瘘联合脉络宁对梗阻性肾积水患者预后及TGF-β1、α-SMA的影响分析

超声引导下经皮肾穿刺造瘘联合脉络宁对梗阻性肾积水患者预后及TGF-β1、α-SMA的影响分析

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目的 探讨超声引导下经皮肾穿刺造瘘联合脉络宁注射液对梗阻性肾积水患者肾功能及TGF-β1、α-SMA的影响分析.方法选择2014年6月~2016年12月在陕西省核工业二一五医院就诊的梗阻性肾积水患者37例作为研究对象,患者入院后均完善有关检查,排除禁忌症后接受超声引导下经皮肾穿刺造瘘术联合脉络宁注射液治疗.观察手术时间、一次穿刺成功率、术中出血量、住院时间、并发症发生情况、术前、术后3 d、7 d肾功能、术前、术后7 d尿液转化生长因子-β1(TGF-β1)和α-平滑肌动蛋白(α-SMA)水平.结果37例患者手术时间52~93分钟,平均手术时间(62.31±8.26)分钟;一次穿刺成功37例,一次穿刺成功率达100%;术中出血量51~102 mL,平均出血量(80.27±18.15)mL;住院时间3~9 d,平均时间(6.12±1.97)d.37例术后发生造瘘管堵塞3例,发生率为8.11%;造瘘管脱出1例,发生率2.70%;瘘口周围皮炎7例,发生率18.92%.患者术后3d时BUN和Cr与术前相比较均显著降低(P<0.05),术后7 d时BUN和Cr与术前和术后3 d相比较均显著降低(P<0.05).术后7 d时患者的TGF-β1和α-SMA水平与术前相比较均显著降低(P<0.05).结论超声引导下经皮穿刺肾造瘘术联合脉络宁注射液治疗梗阻性肾积水可及时引流尿液,改善肾功能,避免患侧肾脏间质纤维化进展和功能丧失,且成功率高,操作安全.
Effect of ultrasound guided percutaneous nephrostomy combined with Mailuoning on prognosis and TGF- beta 1 and alpha -SMA in patients with obstructive hydronephrosis
Objective To investigate the effect of ultrasound guided percutaneous nephrostomy combined with Mailuoning injection on renal function, TGF- β 1 and α -SMA in patients with obstructive hydronephrosis. Methods 37 cases with obstructive hydronephrosis treated in our hospital from June 2014 to December 2016 were enrolled as the research object, all patients after admission were perfect relevant examination, after exclude contraindications underwent ultrasound-guided percutaneous nephrostomy combined with Mailuoning injection treatment. The operative time, the success rate of first puncture, the amount of bleeding during operation, hospitalization time, incidence of complications, preoperative and postoperative 3 d, 7 d renal function preoperative, postoperative, 7 d urine transforming growth factor β 1 (TGF- β 1) and alpha smooth muscle actin (α -SMA) were observed. Results The operation time was 52~93 minutes in 37 patients, the average operation time was (62.31±8.26) minutes; One puncture was successful in 37 cases, the success rate of one puncture was 100%. The intraoperative blood loss was 51 ~ 102 mL, the average amount of bleeding was (80.27±18.15) mL. The hospitalization time was 3 ~ 9 d, the average time was (6.12±1.97)d.In 37 cases, three cases were blocked by ostomy, the incidence rate was 8.11 %; The fistula was removed in one cases, the incidence rate was 2.70%; seven cases with dermatitis around the fistula, the incidence rate was 18.92%. At 3 d after surgery, BUN and Cr were significantly decreased than before operation (P<0.05). At 7 d after surgery, BUN and Cr were significantly decreased compared with preoperative and postoperative 3 d (P<0.05). The levels of TGF-β1 and α-SMA in patients were significantly lower than those before operation at 7 days after operation (P<0.05). Conclusion Ultrasound guided percutaneous nephrostomy combined with Mailuoning injection in the treatment of obstructive hydronephrosis can timely drainage of urine, improve renal function, avoid ipsilateral renal interstitial fibrosis. The utility model has the advantages of high rate of success and safe operation.

upper urinary tract obstructionhydronephrosisultrasound guided percutaneous nephrostomytransforming growth factor β 1alpha smooth actinMailuoning injection

朱莉敏、程荣、王亚娟、纪莉、黎静

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陕西省核工业二一五医院 功能科,陕西 咸阳 712000

上尿路梗阻 肾积水 超声引导 经皮肾穿刺造瘘术 转化生长因子-β1 α-平滑肌动蛋白 脉络宁注射液

2017

中国生化药物杂志
南京生物化学制药研究所,全国生化制药情报中心站,中国生化制药工业协会,中国药品生物制品检定所

中国生化药物杂志

ISSN:1005-1678
年,卷(期):2017.37(10)
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