Comparison of the Curative Effect of Minimally Invasive Percutaneous Nephroscopy combined with Ureteroscopy in the treatment of Complicated Upper Ureteral Calculi
FAN Xueyong
Chaoyang Central Hospital, Liaoning Chaoyang 122000, China
Abstract：Objective: To compare the curative effect of minimally invasive percutaneous nephroscope combined with ureteroscope for the treatment of complicated upper ureteral calculi. Methods: 70 patients with complicated upper ureteral calculi in our hospital from January 2016 to December 2018 were selected and randomly divided into the control group for minimally invasive percutaneous nephrolithotomy and the research group for combined ureteral soft and hard laparoscopy, with 35 cases in each group. The perioperative indicators, stone clearance rate, serum inflammatory factor level and postoperative complications were compared between the two groups. Results: The amount of blood loss in the study group was significantly reduced compared with the control group, the operation time was significantly prolonged compared with the control group, and the length of hospital stay was significantly shortened compared with the control group (P<0.01). The stone clearance rate (94.29%) in the study group was significantly higher than that in the control group (71.43%) (P<0.05). However, there was no significant difference in the stone clearance rate (100.00% vs. 91.43%) between the two groups at 12 weeks after surgery (P>0.05). Serum levels of C-reactive protein (CRP) and interleukin-6 (IL-6) were significantly higher in the two groups one week after surgery than those before surgery, while serum levels of CRP and IL-6 in the study group were significantly lower than those in the control group (P<0.01). There was no significant difference in the incidence of postoperative fever, pyelonephritis and low back pain between the two groups (P>0.05). Conclusion: Compared with minimally invasive percutaneous nephroscopy, combined ureteroscopy with soft and hard ureteroscopy can effectively improve the treatment effect of patients with complicated upper ureteral calculi, with significant clinical efficacy, and can alleviate the inflammatory reaction of the body, with good efficacy and safety, so it is worthy of clinical application.
范学勇. 微创经皮肾镜与输尿管软硬镜联合治疗输尿管上段复杂结石的疗效对比[J]. 河北医学, 2019, 25(12): 2022-2025.
FAN Xueyong. Comparison of the Curative Effect of Minimally Invasive Percutaneous Nephroscopy combined with Ureteroscopy in the treatment of Complicated Upper Ureteral Calculi. HeBei Med, 2019, 25(12): 2022-2025.
[1] Drake T, Grivas N, Dabestani S, et al. What ale the benefits and harms of ureteroscopy compared with shock-wave lithotripsy in the treatment of upper ureteral stones A Systematic Review[J].Eur Urol,2017,72(5):772. [2] Sadi T, Ozan E, Lokman I, et al. Is semirigid ureteroscopysufficient in the treatment of proximal ureteral stones When is combinedtherapy with flexible ureteroscopyneeded[J]. Springerplus,2016,5(1):30. [3] 卓栋,李茂林.输尿管硬软镜联合治疗复杂性输尿管上段结石[J].皖南医学院学报,2017,36(1):44~45. [4] Proietti S, Dragos L, Molina W, et al. Comparison of new single-use digital flexible ureteroscope versus nondisposable fiber optic and digital ureteroscope in a cadaveric model[J].Endourol,2016,30(6):655~659. [5] 黄跃胜,黄海鹏,朱心燊,等.输尿管镜下钬激光碎石术对结石清除率术后并发症及临床疗效的影响[J].河北医学,2017,23(1):152~154. [6] Jiang JT, Li WG, Zhu YP, et al. Comparison of the clinical efficacy and safety of retroperitoneal laparoscopic ureterolithotomy and ureteroscopic holmium laser lithotripsy in the treatment of obstructive upper ureteral calculi with concurrent urinary tract infections[J].Lasers Med Sci,2016,31(5):915~920. [7] Shao Y, Wang DW, Lu GL, et al. Retroperitoneal laparoscopic ureterolithotomy in comparison with ureteroscopic lithotripsy in the management of impacted upper ureteral stones larger than 12 mm[J].World Urol,2015,33(11):1841~1845. [8] 杨关天,杨正平,杨建军,等.输尿管软镜钬激光碎石术治疗复杂性输尿管上段结石[J].江苏医药,2016,42(21):2402~2404. [9] Hamdy A. Fluoroscopy free flexible ureteroscopy withholmium: Yttrium-aluminium-garnet laser lithotripsy forremoval of renal calculi[J]. Arab Urol,2016,14(2):123~130.
2019, Vol. 25 
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