关键词: 复杂性肾结石, 单通道输尿管软镜经皮肾镜取石术, 经皮肾通道输尿管软镜钬激光碎石术, 清石成功率, 肾功能

Abstract: Objective To explore the clinical efficacy of percutaneous ureteral flexible ureteral holmium laser lithotripsy (PNHLL) and single ureteral flexible percutaneous nephrolithotomy (ECIRS) in the treatment of complex kidney stones.Methods The clinical data of 103 patients with complex renal calculi admitted to our hospital from January 2015 to March 2023 were retrospectively analyzed.According to the surgical methods,they were divided into PNHLL group (53 cases) and ECIRS group (50 cases).The perioperative related indicators,stone clearance rate,renal function,stress response and postoperative complications were compared between the two groups.Results The operation time of ECIRS group was longer than that of PNHLL group[(97.62±19.52) min vs.  (72.43±14.48) min] ,and the success rate of stone removal was higher than that of PNHLL group[92.00% (46/50) vs .75.47% (40/53)]  (P<0.05).After operation,the levels of blood urea nitrogen (BUN) [(15.44±3.08)mmol/L vs. (17.21±3.44)mmol/L],cystatin C (CysC) [(611.85±34.22)μg/L vs(637.42±35.41)μg/L],creatinine (Scr) [(77.52±8.64)μmol/L vs. (81.63±9.07)μmol/L],superoxide dismutase (SOD) [(108.64±7.24)U/ml vs. (115.27±7.68)U/ml],prostaglandin E2 (PGE2) [(162.41±18.05)μmol/L vs.(175.48±19.47)μmol/L],nitric oxide (NO) [(74.61±8.29)μmol/L vs.(78.58±8.73)μmol/L] and cortisol (Cor)  [(188.64±29.02)nmol/L vs.(212.42±32.68)nmol/L]in ECIRS group were lower than those in PNHLL group (P<0.05).Conclusion Compared with PNHLL,ECIRS has a higher success rate of stone clearance in the treatment of complex renal calculi,and has less renal function and postoperative traumatic stress response,which is beneficial to postoperative recovery.

Key words: complex renal calculi, single channel flexible ureteroscope percutaneous nephrolithotomy, percutaneous flexible ureteroscopic holmium laser lithotripsy, the success rate of stone clearance, renal function