WANG Peilong, LI Xiaoran, HE Qiqi, MA Teng, FU Xiaobao, BAO Junsheng, YANG Ningqiang. Comparison of the effects of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope and flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones[J]. Journal of Clinical Medicine in Practice, 2023, 27(2): 101-104, 112. DOI: 10.7619/jcmp.20221893
Citation: WANG Peilong, LI Xiaoran, HE Qiqi, MA Teng, FU Xiaobao, BAO Junsheng, YANG Ningqiang. Comparison of the effects of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope and flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones[J]. Journal of Clinical Medicine in Practice, 2023, 27(2): 101-104, 112. DOI: 10.7619/jcmp.20221893

Comparison of the effects of single-channel percutaneous nephrolithotomy combined with flexible ureteroscope and flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones

More Information
  • Received Date: June 16, 2022
  • Available Online: February 17, 2023
  • Objective 

    To compare the effects of single-channel percutaneous nephrolithotomy (PCNL) combined with flexible ureteroscope with flexible ureteroscopic holmium laser lithotripsy in the treatment of complex kidney stones.

    Methods 

    A total of 101 patients with complicated kidney stones were selected as study objects, and were divided into two groups according to different treatment plans. The control group (n=49) received flexible ureteroscopic holmium laser lithotripsy, and the observation group (n=52) received single-channel PCNL combined with flexible ureteroscope treatment. The operation conditions, renal function [neutrophil gelatinase-associated apolipoprotein (NGAL), cystatin C (Cys-C), and blood creatinine (Scr)], stress indicators [adrenocorticotropic hormone (ACTH), norepinephrine (NE), and cortisol (Cor)], complications and stone clearance rate were compared.

    Results 

    The recovery time of gastrointestinal function and hospital stay in the observation group was (3.84±1.02)d, (7.14±1.56) d, which were shorter than(4.42±1.39) d, (9.42±1.79)d of the control group (P < 0.05); the operation time in the observation group was (72.15±5.56) min, which was longer than (69.08±6.01) min in the control group (P < 0.05). The NGAL, Cys-C, Scr, ACTH, NE, and Cor in the two groups after operation were higher than those before operation, and NGAL, Cys-C, Scr, ACTH, NE, and Cor in the observation group were lower than those in the control group (P < 0.05). The total incidence of complications in control group and observation group were 10.20% and 3.85%, respectively, but no significant difference was found (P>0.05). The stone clearance rate in the observation group was 100.00%, which was higher than 87.76% in the control group, and the difference was statistically significant (P < 0.05).

    Conclusion 

    Compared with flexible ureteroscopic holmium laser lithotripsy, single-channel PCNL combined with flexible ureteroscope for patients with complex kidney stones has higher stone clearance rate, shorter postoperative gastrointestinal function recovery time, less damage to kidney function, and small stress response, and can make the patients discharge as soon as possible, but it has longer operation time.

  • [1]
    王友铭, 许长宝, 王晓甫, 等. 河南省泌尿系结石住院患者流行病学特点及分析[J]. 临床泌尿外科杂志, 2021, 36(6): 458-463. https://www.cnki.com.cn/Article/CJFDTOTAL-LCMW202106007.htm
    [2]
    龚宾宾, 王建忠, 徐雨辰, 等. 经皮肾镜碎石术治疗复杂性肾结石术后结石残余的危险因素分析[J]. 安徽医学, 2019, 40(11): 1193-1197. https://www.cnki.com.cn/Article/CJFDTOTAL-AHYX201911002.htm
    [3]
    葛长龙, 白瑛璋, 孟祥楠. 多通道经皮肾镜与单通道PCNL联合输尿管软镜治疗复杂性肾结石的临床疗效及安全性比较[J]. 临床和实验医学杂志, 2021, 20(3): 293-296. https://www.cnki.com.cn/Article/CJFDTOTAL-SYLC202103020.htm
    [4]
    郑防军. 标准单通道经皮肾镜取石术治疗肾脏铸型结石的疗效[J]. 实用临床医药杂志, 2020, 24(11): 25-27, 31. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202011007.htm
    [5]
    陈志强. 单通道微创经皮肾镜取石术联合输尿管硬镜对复杂性肾结石患者肾功能影响的初步研究[J]. 解放军预防医学杂志, 2018, 36(11): 1415-1418. https://www.cnki.com.cn/Article/CJFDTOTAL-JYYX201811016.htm
    [6]
    丁睿, 顾震华, 陈健, 等. 加速康复外科模式下输尿管软镜治疗直径小于2 cm肾及输尿管上段结石的疗效分析[J]. 实用临床医药杂志, 2020, 24(5): 86-88, 91. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202005023.htm
    [7]
    梁镇锋, 黄荏钊, 张增强, 等. 输尿管软镜钬激光碎石术与微创经皮肾镜碎石术治疗2~3 cm肾结石的疗效比较[J]. 河北医学, 2020, 26(11): 1854-1858. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX202011022.htm
    [8]
    HYAMS E S, MONGA M, PEARLE M S, et al. A prospective, multi-institutional study of flexible ureteroscopy for proximal ureteral stones smaller than 2 cm[J]. J Urol, 2015, 193(1): 165-169.
    [9]
    邓林, 张力, 李涵, 等. 一期单通道微创经皮肾镜取石术与多通道微创经皮肾镜取石术治疗复杂性肾结石效果的比较研究[J]. 中国医学前沿杂志: 电子版, 2020, 12(7): 182-186. https://www.cnki.com.cn/Article/CJFDTOTAL-YXQY202007039.htm
    [10]
    冉茂彪, 李开毅, 康卫民, 等. 微创钬激光碎石术与开放性取石术治疗复杂性肾结石的临床疗效[J]. 中国激光医学杂志, 2020, 29(2): 88-91. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGJG202002006.htm
    [11]
    段灵星, 匡仁锐, 张谏, 等. 单通道与多通道经皮肾镜取石术治疗复杂性肾结石有效性和安全性的Meta分析[J]. 转化医学杂志, 2019, 8(1): 45-49. https://www.cnki.com.cn/Article/CJFDTOTAL-HJZY201901012.htm
    [12]
    李晖, 梁发, 刘毓, 等. 单通道与多通道经皮肾镜取石术用于复杂性肾结石[J]. 中国中西医结合外科杂志, 2018, 24(3): 335-338. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGZX201803022.htm
    [13]
    马龙, 王卫妮, 张争春, 等. 多通道与单通道经皮肾镜取石术联合输尿管软镜治疗复杂性肾结石[J]. 西部医学, 2017, 29(12): 1714-1717, 1722. https://www.cnki.com.cn/Article/CJFDTOTAL-XIBU201712020.htm
    [14]
    周青, 舒畅, 朱云海, 等. 输尿管软镜碎石术对直径小于2 cm的肾结石患者应激反应及炎症指标的影响[J]. 实用临床医药杂志, 2020, 24(8): 33-35. https://www.cnki.com.cn/Article/CJFDTOTAL-XYZL202008009.htm
    [15]
    葛斌, 刘艳, 徐革, 等. 建立NGAL诊断阈值有利于临床判断和发现急性肾功能损伤[J]. 基因组学与应用生物学, 2019, 38(3): 1434-1441. https://www.cnki.com.cn/Article/CJFDTOTAL-GXNB201903069.htm
    [16]
    王凯, 郑颖颖, 唐俊楠, 等. 血肌酐水平对肾功能正常的冠心病PCI术后患者预后的影响[J]. 郑州大学学报: 医学版, 2020, 55(3): 308-311. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK202003004.htm
    [17]
    池锐彬, 邹启明, 李超锋, 等. 不同时刻血肌酐水平对危重症患者急性肾损伤预后的影响[J]. 中华急诊医学杂志, 2019, 28(9): 1083-1087.
    [18]
    康启源, 张辉, 毕航, 等. 输尿管镜下钬激光与气压弹道碎石术对老年输尿管上段结石患者应激反应及碎石效果的比较[J]. 中华老年多器官疾病杂志, 2019, 18(2): 127-131. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLQG201902007.htm
    [19]
    李铁, 刘平, 刘迪. ESWL与mPCNL治疗上尿路结石的疗效、应激反应及血流动力学对比研究[J]. 重庆医学, 2021, 50(11): 1830-1833, 1838. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202111007.htm
    [20]
    杨小杰, 李友芳, 王茜, 等. 超声引导下微通道经皮肾镜取石术治疗肾结石的疗效及对机体应激反应的影响[J]. 疑难病杂志, 2019, 18(5): 477-481. https://www.cnki.com.cn/Article/CJFDTOTAL-YNBZ201905012.htm
    [21]
    陈悦, 叶青青, 吴浩. 竖脊肌平面阻滞对肾结石病人术后痛敏反应及伤害应激反应的影响[J]. 临床外科杂志, 2022, 30(3): 284-286. https://www.cnki.com.cn/Article/CJFDTOTAL-LCWK202203023.htm
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