摘要
目的探讨B超引导下注入聚桂醇对单纯性肾囊肿患者应激相关指标的影响。方法将2014年11月至2015年11月武汉科技大学附属医院收治的单纯性肾囊肿患者86例按随机数表法分为观察组与对照组各43例,对照组采用无水乙醇为硬化剂,观察组采用聚桂醇为硬化剂,比较两组围术期应激相关指标、临床疗效及不良反应。结果两组患者术后12 h各应激指标水平除舒张压外均明显高于其余各时段的检测水平,且差异有统计学意义(P<0.05)。其中观察组术后48 h血清应激指标血清皮质醇(Cor)[(201.22±16.27)ng/mL vs(199.58±23.47)ng/mL]、肾上腺素(AD)[(0.14±0.05)ng/mL vs(0.14±0.03)ng/mL]、去甲肾上腺素(NE)[(267.09±20.54)ng/mL vs(262.17±19.98)ng/mL]及血管紧张素Ang-Ⅱ[(51.34±6.84)pg/mL vs(49.99±6.78)pg/mL]及体征应激指标体温[(36.2±0.4)℃vs(36.3±0.2)℃]、收缩压[(121.6±13.8)mmHg vs(120.3±14.5)mmHg]及血糖[(5.2±0.9)mmol/L vs(4.9±0.7)mmol/L]与术前水平比较差异均无统计学意义(P<0.05)。对照组术后72 h血清应激指标Cor[(203.22±18.01)ng/mL vs(201.47±20.13)ng/mL]、AD[(0.15±0.04)ng/mL vs(0.15±0.03)ng/mL]、NE[(267.10±21.45)ng/mL vs(264.54±21.38)ng/mL]及Ang-Ⅱ[(49.86±6.25)pg/mL vs(50.65±5.67)pg/mL]及体征应激指标体温[(36.2±0.1)℃vs(36.2±0.3)℃]、收缩压[(122.9±13.2)mmHg vs(123.4±11.3)mmHg]及血糖[(5.2±0.8)mmol/L vs(5.1±0.6)mmol/L]与术前水平比较差异均无统计学意义(P>0.05)。观察组患者临床治疗的总有效率为93.0%,明显高于对照组的69.8%,差异有统计学意义(P<0.05);观察组发生过敏及血尿例数与对照组比较差异无统计学意义(P>0.05),而观察组出现腰部酸胀(4.7%)及发热(2.3%)的比例明显低于对照组(20.9%、25.6%),且差异具有统计学意义(P<0.05)。结论采用聚桂醇为硬化剂对单纯性肾囊肿患者进行B超引导治疗,不仅能够对各应激指标有调节作用,同时能提高疗效,降低不良反应发生率。
Objective To study the influence of ultrasound-guided injection of lauromacrogol on the stress response of patients with simple renal cyst. Methods Eighty-six patients with simple renal cyst from November 2014 to November 2015 in our hospital divided into observation group（n=43） and control group（n=43）, which received lauromacrogol and absolute ethyl alcohol as sclerosis, respectively. The stress response indexes, clinical effect and side effect in of two groups were compared. Results The levels of stress response indexes（except diastolic pressure） 12 h after operation were all significantly higher than the levels at other time points（P0.05）. The levels of stress response indexes of cortisol（Cor）,adrenalin（AD）, noradrenalin（NE）, Ang-Ⅱ, body temperature, systolic pressure, and blood sugar 48 h after operation in the observation group showed no statistically significant difference with those before operation（P0.05）： Cor（201.22 ±16.27） ng/mL vs（199.58±23.47） ng/mL, AD（0.14±0.05） ng/mL vs（0.14±0.03） ng/mL, NE（267.09±20.54） ng/mL vs（262.17±19.98） ng/mL, Ang-Ⅱ（51.34±6.84） pg/mL vs（49.99±6.78） pg/mL, body temperature（36.2±0.4）℃ vs（36.3±0.2）℃, systolic pressure（121.6±13.8） mmHg vs（120.3±14.5） mmHg, and blood sugar（5.2±0.9） mmol/L vs（4.9±0.7） mmol/L. The levels of stress response indexes of Cor, AD, NE, Ang-Ⅱ, body temperature, systolic pressure, and blood sugar in the control group72 h after operation were also not significantly different from those before operation（P0.05）： Cor（203.22±18.01） ng/mL vs（201.47±20.13） ng/mL, AD（0.15±0.04） ng/mL vs（0.15±0.03） ng/mL, NE（267.10±21.45） ng/mL vs（264.54±21.38） ng/mL,Ang-Ⅱ（49.86±6.25） pg/mL vs（50.65±5.67） pg/mL, body temperature（36.2±0.1）℃ vs（36.2±0.3）℃, systolic pressure（122.9 ± 13.2） mmHg vs（123.4 ± 11.3） mmHg, blood sugar（5.2 ± 0.8） mmol/L vs（5.1 ± 0.6） mmol/L. Compared with the control group, the observation group had significant higher total clinical effective rate（93.0% vs 69.8%, P0.05）. The allergies and hematuria cases in observation group and control group had no significant difference（P0.05）. The incidence of swollen and fever were 4.7%, 2.3% in the observation group versus 20.9%, 25.6% in the control group（P0.05）. Conclusion The use of lauromacrogol as sclerosis in patients with simple renal cysts for ultrasound-guided therapy can not only regulate the stress indexes, but also improve the clinical efficacy and reduce the incidence of adverse reactions.
出处
《海南医学》
CAS
2018年第2期170-173,共4页
Hainan Medical Journal
基金
湖北省自然科学基金项目(编号:2014CFB964)
关键词
B超引导
硬化剂
聚桂醇
肾囊肿
应激
Ultrasound-guided
Sclerosis
Lauromacrogol
Renal cyst
Stress response
