Effect of standard channel percutaneous nephrolithotomy combined with flexible ureteroscopic holmium laser lithotripsy on stone clearance,renal function and hemodynamics in patients with upper urinary tract stones
Objective To investigate the effects of standard channel percutaneous nephrolithotomy(SPCNL) combined with flexible ureteroscopic holmium laser lithotripsy(FURS) on stone clearance,renal function and hemodynamics in patients with upper urinary tract stones.Methods From March 2017 to June 2019,84 cases of hospitalized patients with urinary stones,refer to the random number table method who were divided into two groups, one group as the control group,another group to group,each group with 42 cases,the former channel use standard percutaneous nephrolithotomy treatment,after the channel combination standard percutaneous nephrolithotomy with soft ureter mirror holmium laser lithotripsy treatment.Renal function indexes(2-microglobulin,creatinine,urea) and hemodynamic indexes(central venous pressure,mean arterial pressure and heart rate) before and after surgery were compared with postoperative stone clearance rate,operation time,indwelling time of renal fistula, hospitalization time and incidence of complications.Results There was no difference in preoperative renal function and hemodynamic indexes between the two groups(P>0.05).Compared with the preoperative level,the postoperative renal function indexes of the two groups were higher(P<0.05), and the hemodynamic indexes showed no difference(P>0.05).There was no difference in postoperative renal function,hemodynamics and complication rate between the two groups(P>0.05).Compared with the control group, the study group had higher postoperative stone clearance rate, longer operation time,shorter indwelling time and hospital stay for renal fistula(P<0.05).Conclusions Percutaneous nephrolithotomy combined standard channel soft ureter mirror holmium laser lithotripsy on the treatment of urinary stones,though the joint operation of operation time is longer than standard channel percutaneous nephrolithotomy alone,but the postoperative calculi clearance rate is higher,and less effect on the patients with hemodynamic indexes, which can effectively improve renal function,further to promote patients' rapid recovery.