关键词: 输尿管软镜, 碎石术, 肾结石, 肾功能, 炎性因子

Abstract: Objective To investigate the effect of ureteroscopic lithotripsy on renal function and inflammatory factors in patients with renal stones with diameter of 2-3cm.Methods A total of 68 patients with nephrolithiasis admitted to Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2020 to January 2022 were selected and divided into microchannel percutaneous nephroscopy group and flexible ureteroscopy group by digital parity method,with 34 cases in each group.The operation time,intraoperative blood loss,postoperative hospital stay,renal function indexes [blood urea nitrogen(BUN),serum creatinine(sCr),24h urinary protein(24h Upro)],inflammatory factors [C-reactive protein(CRP),interleukin 6(IL-6),procalcitonin(PCT)] level and postoperative complications were compared between the two groups.Results There was no significant difference in the operation time between the two groups [(58.75±10.23)min vs(53.82±11.65)min](P＞0.05).The intraoperative blood loss in the flexible ureteroscope group was less than that in the percutaneous nephroscope group,which was(5.07±1.32)ml and(12.84±2.18)ml,respectively.The difference between the two groups was statistically significant(P＜0.05).The postoperative hospital stay of the the flexible ureteroscope group was shorter than that in the percutaneous nephroscope group[(2.94±0.87)days and(5.21±1.03)days,respectively],with a statistically significant difference between the two groups(P＜0.05).The BUN [(3.16±1.65)mmol/L vs(4.82±1.83)mmol/L],sCr [(60.48±12.74)μmol/L vs(72.85±15.36)μmol/L] and 24h Upro [(0.12±0.02)g vs(0.18±0.05)g] were lower than those in the percutaneous nephroscopy group(P＜0.05).Three days after operation,the flexible ureteroscopy group CRP [(21.65±4.63)mg/L vs(32.86±4.87)mg/L],IL-6 [(25.45±5.86)ng/L vs(32.21±7.21)ng/L] and PCT [(2.15±0.94)μg/L vs(3.68±1.32)μg/L] levels were lower than those in the percutaneous nephroscopy group(P＜0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(5.88% vs 14.71%)(P＞0.05).Conclusion Flexible ureteroscopic lithotripsy for patients with 2-3cm kidney stones can reduce intraoperative blood loss,shorten hospital stay,improve renal function,and reduce the level of inflammatory factors.

Key words: flexible ureteroscopy, lithotripsy, renal calculi, renal function, inflammatory factors