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- Publisher
- Hindawi Publishing Corporation
- Copyright
- Copyright © 2022 Si Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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- 2040-2295
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- 2040-2309
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- 10.1155/2022/4373416
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Abstract
Hindawi Journal of Healthcare Engineering Volume 2022, Article ID 4373416, 6 pages https://doi.org/10.1155/2022/4373416 Research Article Analysis of the Mechanism of Ureproofing Technology and Postlaparoscopy on Patients with Urology and Infection 1 2 1 1 1 Si Chen, Yuanfeng Zhang, Peilin Shen, Zhuangcheng Huang, Mingen Lin, and Jiansheng Huang Department of Urology, e First Aliated Hospital of Shantou University Medical College, Shantou, Guangdong 515041, China Department of Urology, Shantou Central Hospital, Shantou, Guangdong, China Correspondence should be addressed to Jiansheng Huang; 10zchuang1@stu.edu.cn Received 4 January 2022; Revised 27 February 2022; Accepted 7 April 2022; Published 21 April 2022 Academic Editor: Liaqat Ali Copyright © 2022 Si Chen et al. �is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Objective. To analyze the eƒect of ureteroscopy and retrolaparoscopy on urinary calculi and infection. Method. A total of 64 patients with urinary calculi and infection who received treatment in our hospital from June 2018 to January 2018 were selected. According to the diƒerent treatment methods, they were divided into two groups: a control group and a study group. �e study group was treated with laparoscopic ureteroscopy, and the control group was treated with ureteroscopy. �e surgical results, complications, renal function, stress response, and inˆammatory reaction were compared between the two groups. Results. Compared with the control group, the study group stone clearance rate was higher, the surgical time was shorter (P < 0.05); the incidence of complications in the study group (23.3%) was lower than that in the control group (5.9%) (P < 0.05); there was no signi’cant diƒerence in kidney function indicators before treatment (P > 0.05); after treatment, the SCR, BUN, NGAL, and Cys-C indicators of the two groups were signi’cantly increased. Compared with the control group, the study group change was more obvious, and the diƒerence was statistically signi’cant (P < 0.05); after treatment, the two sets of stress response indicators were signi’cantly increased, but relative to the control group, the study group stress response indicator was lower (P < 0.05); before treatment, there was no signi’cant diƒerence in inˆammatory factors (P > 0.05); after treatment, the two sets of inˆammatory factor levels were signi’cantly increased, but relative to the control group, the study group was lower (P < 0.05). Conclusion. In the clinical treatment of urinary stones, ureteroscopy technology and the laparoscopic technique have played an important role. But the laparoscopic technique is shorter, the stone clearance is higher, and the patient’s renal function can be improved, and the patient is postoperative. �e stress reaction should be small. �erefore, in the clinical treatment of urinary stones and infection, laparoscopic technical treatment is worth promoting. blocked above the stone, and there will be little stone residual 1. Introduction phenomenon[4,5].However,thecurrentresearchonthesafety �e ureter, urethra, and bladder are prone to highly path- andmechanismoftheabovementionedtwotreatmentmethods ogenic disease, and the clinical treatment of ureteral calculi is is limited. �e study selection included 64 cases of urinary focused on [1]. Data show that about 70% of ureteral stones stones admitted toour hospital from June 2018 to January 2021, can be passed naturally. If the past medical history is large, it andtheabovementionedtwomethodswereselected.�ereport is di¡cult to discharge naturally [2]. At present, urological of the analysis of the treatment eƒects of urinary stones in equipment is becoming more and more advanced, surgical infected patients is further discussed in this study. technology is improving, and ureteroscopy and laparoscopy have been widely used [3]. 2. Data and Methods Duetotheureteralmirrorcrimpingstone,thestoneresidue is prone to stones, but the laparoscopic urinary tube is cut into 2.1. General Information. A total of 64 patients with urinary the ureteral tour at the stone, and the ureteral expansion is tract stones complicated by infection who were treated in 2 Journal of Healthcare Engineering Stress Reaction [7]: serum tyrosinase (NE), adrenal our hospital from June 2018 to January 2018 were selected and divided into the control group and the study group hormone (ACTH), cortical hormone (COR) index, application of enzyme-linked immunosorbent assay according to different treatment methods. )e study group (n � 34) had 18 males and 16 females with an average age of (ELISA), and fat were provided by American Beckman 48.5± 5.5; the control group (n � 30) had 16 males and 14 Box, and the operation was carried out according to the with an average age of 48.3± 5.6. )is study was approved by instruction manual the patients’ consent and the hospital ethics committee, and Inflammatory Reaction [8]: application of immuni- the data were comparable (P> 0.05). mosis for the detection of C-reactive protein (CRP), automatic biochemical analyzer is applied to detect Inclusion Criteria: (1) age of 20–72; (2) imaging and white blood cells (WBCs), application of the enzyme clinical diagnosis of CT and ultrasound, diagnosed as immunization adsorption method to detect interleu- urinary stones and infected; (3) acceptable forecast kin-10 (IL-10) follow-up; and (4) high quality, which can be combined with the researcher Exclusion Criteria: (1) congenital ureteral narrow mal- 2.4. Statistical Method. )e data were analyzed and pro- formation; (2) urinary tuberculosis and ureterodialysis; (3) cessed by SPSS22.0 statistical software. )e quantitative data combined with hemorrhagic diseases; (4) hepato cutter is were represented by the mean± standard deviation, the T abnormal; (5) kidney damaged features due to consoli- test was performed, group data were analyzed by variance, dation of severe renal water; and (6) surgical the X test was used for qualitative data, two-sided test contraindications statistics were used, and P< 0.05 was different; graphs were used. Rates were made by GraphPad Prism 8, P< 0.05 was 2.2. Method significantly different. (1) Laparoscopic ureterotomy: the patient is placed in a 3. Results supine position, tracheal intubation is anesthetized, and the dilated ureter bursts at the extraction site of 3.1. General Data Analysis of Two Groups. In the control the lower part of the kidney, which can be freely group and research group, gender, age, preoperative culture descended. )e ureter is clamped by the separation positive, and preoperative indwelling double J tube rate, clip, the electric hook is removed longitudinally, the there is a statistical significance (P> 0.05) (Table 1). ureter is cut off, and the stone is taken out. )e 5f double-J tube was inserted through the proximal and distal ends of the ureteral incision, and absorbable 3.2. Surgical Results of Two Groups Were Analyzed in Two sutures were selected to suture the ureteral incision, Groups of Hospitalization Time. )e time of use of post- leaving the abdominal drainage tube. operative analgesia did not show a significant difference (2) Ureteroscopic lithotripsy: the patient was placed in a (P> 0.05). In the control group and the study group, the supine position, and the back was anesthetized with stone clearance was 81.7% and 100%, respectively. In hard lumbar anesthesia, and an 8/9.8F ureteroscope comparison, the stones of the study group were higher, the was placed in the urethra. Under the guidance of a surgical time was shorter, and there was statistical signifi- zebra wire, it is placed into the patient’s ureter to cance (P< 0.05) (Table 2). control the appropriate perfusion pressure. After the stone was detected, the holmium laser 400 μm fiber 3.3. Comparison of Complications between the Two Groups. had reached the catheter, and the edge of the stone )e incidence of complications in the study group was lower was gradually crushed. Finally, the retrograde 5F than that in the control group (Figure 1). double J tube. 2.3. Observation Indicator 3.4. Two-Group Kidney Function Index Contrast. Before the analysis of kidney function indicators, the two groups of Surgical Results: it includes the operation time, hos- renal function indicators have no significant difference pitalization time, postoperative analgesic pump, calculi (P> 0.05). After treatment, SCR, BUN, NGAL, and Cys-C clearance rate, and polyps discovery rate indicators of two groups were significantly increased. Complications: statistical ureteral vacation, fever, in- Compared with the control group, the study group change is cision infection patients, and calculation incidence more obvious, and there is a statistical significance of the Renal Function [6]: 3 ml of venous blood is taken, difference (P< 0.05) (Figure 2). centrifuged at 3000 rpm for 10 minutes, and an auto- matic biochemical analysis of serum, serum creatinine (SCR), blood urea nitrogen (BUN), and apolipoprotein 3.5. Comparison of Two Groups of Oxidative Stress Indicators. (NGAL) indicators instrument (Ponzi Medical, model: )ere was no significant difference in oxidative stress in- PUZS-300X) is used and operated according to the dicators between the two groups (P> 0.05), and the stress instruction manual response indicators in the two groups were significantly Journal of Healthcare Engineering 3 Table 1: Analysis of the general data of two groups. Project Control group (n � 30) Research group (n � 34) X /t P Gender (male/female) 16/14 18/16 0.682 ＞0.05 Age 48.3± 5.6 48.5± 5.5 1.524 ＞0.05 Preoperative urine culture positive (example, %) 5 (16.7) 5 (14.7) 0.638 ＞0.05 Introduction double J tube (example, %) before surgery 20 (66.7) 23 (67.6) 1.724 ＞0.05 Table 2: Analysis of the surgical results of the two groups. Surgery Hospital Postoperative analgesia Polyps discovery Group Count Stone clearance (%) time (min) stay (day) pump usage time (D) rate (%) Control group 30 49.3± 7.8 5.2± 1.4 2.2± 0.6 49 (81.7) 33 (55.0) Research group 34 41.4± 5.4 5.1± 1.3 2.3± 0.5 68 (100.0) 37 (54.4) X — 17.625 1.082 1.824 5.638 0.724 P — ＜0.05 ＞0.05 ＞0.05 ＜0.05 ＞0.05 low wound surface. Combined with laser treatment, it can effectively crush stones. Stenosis can be treated concurrently, but ureteral stones are less effective [14, 15]. )e main reasons are that the ureteral walker is long, stones are often used by ureteral budding polyps, and factors such as ureteral transformation will also affect the treatment effect. )e high rate of ureteral perforation and tearing enables the clinical treatment of ureteral mirror crimping stones [16, 17]. )erefore, when choosing the treatment method for ureteral calculi, the situation of the distal ureter should be com- prehensively analyzed. Ureteroscopy is widely used in the treatment of larger ureteral calculi, and the treatment effect is good and the safety is relatively high [18]. After the end of the study, the patients were treated with ureteroscopy. No obvious complications were found, and the prognosis of the patients was good [19]. During ureteroscopy treatment, stone movement is common, and the following measures Control group can be taken to reduce the incidence of stones on stones. )e research group patient’s position is lower than their head [20]. Second, perform low-pressure perfusion during operation, main- Figure 1: Comparison of complications between the two groups. taining low-speed flushing. )ird, when placing the ureteral stent, the edge should be placed on the edge of the stone and increased after treatment, which should be higher in the should be pressed to the ureteral side [21]. Fourth, when study group than in the control group (P< 0.05) (Figure 3). selecting cases, the specific characteristics of the patients should be considered, and patients with a combined case 3.6. Comparison of Inflammatory Response Indexes between with a stone diameter greater than or equal to 1.0 cm, a fixed the Two Groups. )ere was no significant difference in in- stone, and a longer course of disease should be selected [22]. flammatory factors between the two groups before treatment In urology, laparoscopy has been widely used, which has (P> 0.05),andaftertreatment,theinflammatoryfactorsinthe accelerated the progress of ureteral diameter technology. It twogroupsweresignificantlyincreased,butcomparedwiththe has the characteristics of fast postoperative recovery and controlgroup,thestudygroupwaslower (P< 0.05)(Figure4). small damage, which can make up for the defects of tra- ditional open surgery and be used for the treatment of ureteral stones [23]. Laparoscopic urinalysis can complete 4. Discussion one-time stones, but laparoscopy is skilled. In this study, )e treatment of ureteral calculi is particularly special, and laparoscopy was used to treat patients with ureteral calculi, open surgery, ureteroscopy, laparoscopy, and transdermal and the effect was satisfactory, with a stone clearance rate of nephroscopy are often used [9–11]. Minimally invasive 100% and a shorter operation time [24]. )is study analyzed surgery is used if the patient has contraindications to tra- the effects of ureteroscopy and laparoscopy on the prog- ditional surgery [12, 13]. At present, laparoscopy and ure- nosis of patients with urinary calculi and infections. )e teroscopy have been widely used in the treatment of urology, incidence of complications was consistent with the findings of other scholars. )e results confirmed that laparoscopic and ureteroscopic lithotripsy can be operated according to the characteristics of the human body’s natural cavity and urinary tandem resection had lower complication rates and Ureteral prosthesis fever Incision infection Incidence 4 Journal of Healthcare Engineering 21 days after treatment 21 days after treatment 14 days after treatment 14 days after treatment 7 days after treatment 7 days after treatment before therapy before therapy 0 50 100 150 200 250 0 50 100 150 200 250 BUN (mmol/L) Scr (μmol/L) Control group Control group research group research group (a) (b) 21 days after treatment 21 days after treatment 14 days after treatment 14 days after treatment 7 days after treatment 7 days after treatment before therapy before therapy 0 5 101520 0 500 1000 1500 NGAL (µg/L) Cys-C (µg/L) Control group Control group research group research group (c) (d) Figure 2: Two-group kidney function index contrast. 240 350 80 200 300 180 40 160 250 120 200 0 Control group Control group Control group research group research group research group (a) (b) (c) Figure 3: Comparison of two groups of oxidative stress indicators. Cor (µg.L-1) before therapy 7 days aer treatment 14 days aer treatment 21 days aer treatment NE (μg.L-1) before therapy 7 days aer treatment 14 days aer treatment 21 days aer treatment ACTH (ng.L-1) before therapy 7 days aer treatment 14 days aer treatment 21 days aer treatment Journal of Healthcare Engineering 5 20 40 40 15 30 30 10 20 20 5 10 10 0 0 0 Control group Control group Control group research group research group research group (a) (b) (c) Figure 4: Comparison of inflammatory response indexes between the two groups. higher surgical success rates compared with ureteroscopic important role, but the laparoscopic surgery time is shorter, culprits. Surgery is an invasive treatment, which will and the stone clearance rate is higher, and the patient’s renal stimulate the body to a certain extent. )e patient will be function can be improved to a greater degree of kidney accompanied by stress, and the immune function of the function. )e patient’s stress reaction should be small after patient will be reduced, which will affect the postoperative surgery. )erefore, in the clinical treatment of urinary stones recovery. Among them, the activation of the hypothalamus- and infection, laparoscopic technical treatment is worth pituitary-adrenal axis is mainly due to the stress response, promoting. and the amount of Ne, ACTH, COR, and other hormones increases significantly, which can reflect the stress state of Data Availability the body [25]. )is study analyzed the effects of uretero- scopy and postlaparoscopic techniques on stress response )e data used to support the findings of this study are available from the corresponding author upon request. indicators in patients with urinary calculi and infection. )e results showed that the stress response indexes of the two groups were significantly increased after treatment, but Conflicts of Interest compared with the control group, the stress response in- dexes of the study group were lower (P< 0.05). )e results )e authors declare that there are no conflicts of interest. confirmed that after reducing the stress response, the ad- vantages of laparoscopic technology were more obvious, Acknowledgments causing less damage to the patient and speeding up the recovery of the disease. )is work in this paper was supported by the Department of Urology, the First Affiliated Hospital of Shantou University However, after the laparoscopic urine test, pay attention to the following aspects: (1) accurately locate by X-ray mode Medical College. before operation, determine the anatomical signs such as calculus, kidney compression, lumbar bust, and peritoneum, References and explore the ureter. 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Journal
Journal of Healthcare Engineering – Hindawi Publishing Corporation
Published: Apr 21, 2022