Effect Of Hemorheology, Glucose And Interleukin-6 In Upper Urinary Tract Stones Patients With Type 2 Diabetes Mellitus During The Percutaneous Nephrolithotomy

Objective To explore perioperative change of physical state conditions of the patients with upper urinary tract stones and type 2 diabetes by observing the effects of mini-percutaneous nephrolithotomy on system hemorheology, blood glucose and immune function during operation. Further,we plan to provide theoretical evidence for clinical treatment.Methods Sixty-four patients with upper urinary tract stones and type 2 diabetes were involved in this study.The control group included sixty patients without diabetes.They all underwent mini-percutaneous nephrolithotomy. There was no significant difference of the age of patient,the mean anaesthesia and the irrigation fluid volume between the two groups. Hemorheology was determined before operation, during operating for 60 minutes and after operation. The random blood glucose were recorded before operation, and after operation for 1 hour and 2 hours. The fasting blood glucose were recorded after operation for 1 day ,3 days and 5 days. The density of IL-6 in plasma were determined before operation, after operation for 1 day and 3 days. SPSS 13.0 statistical software was used.Results Hemorheology indicators in type 2 diabetes group:There was significant decrease of the whole blood viscosity at high and low shear rate, plasma viscosity and HCT at T2 compared with T1(P<0.05). There was significant decrease of the whole blood viscosity at high and low shear rate, plasma viscosity at T3 compared with T1(P<0.05). There was significant decrease of the whole blood viscosity at high shear rate, plasma viscosity at T3 compared with T2(P<0.05). The whole blood viscosity at high and low shear rate, plasma viscosity and HCT in the control group was not significantly different between every two stages(P>0.05). Hemorheology indicators in type 2 diabetes group was significantly different from the control group(P<0.05). Blood glucose: The average blood glucose in type 2 diabetes group after operation for 1 hour and 2 hours significantly increased than preoperative level(P<0.05). The fasting blood glucose were recorded after operation for 1 day ,3 days and 5 days was not significantly different from preoperative level(P>0.05). The average blood glucose in the control group was not significantly different between every two stages(P>0.05). Immune function indicator: The serum IL-6 levels after operation for 1d and the first 3d were increased significantly(P<0.05 or P<0.01).The serum IL-6 levels after operation for 1 day in the control group increased significantlycompared with the preoperative level(P<0.05), and 3d after surgery returned to preoperative levels.The serum IL-6 levels after operation for 3d remained elevated in type 2 diabetes group, with significant difference (P <0.01).Conclusion 1. The blood flow, coagulation and viscosity changes significantly in patients with type 2 diabetes. Monitoring hemorheology during surgery and treating in a timely manner to reduce postoperative complications.2. The postoperative blood glucose levels after l h, 2 h in type 2 diabetic patients in percutaneous nephrolithotomy reach to a small peak, and then decrease gradually.The process of first increase and then decrease can be found in in type 2 diabetic patients but postoperative blood glucose in the control group decreased to the preoperative levels gradually.The discovery of this law will help to guide the doctor treat promptly according to blood glucose level to reduce the incidence of complications at different times after surgery.3. The body's inflammatory response and immune function recovered slowly in patients with type 2 diabetes.