Efficacy of Shuotong Mirror Combined with SMP in the Treatment of Complex Upper Ureteral and Renal Stones and its Effect on Renal Function

Guo Qianjin; He Wenqiang

doi:10.3969/j.issn.1004-5775.2023.23.006

Abstract：Objective:To investigate the efficacy and effect on inflammatory mediators,renal function indices,and safety of Shuotong mirror combined with ultramicrochannel percutaneous nephrolithotripsy(SMP)in the treatment of patients with complex upper ureteral and renal stones.Methods:98 patients with complex upper ureteral and renal stones admitted to the hospital from December 2019 to January 2022 were selected for the study,and the patients were randomly divided into the combined group(n= 49,given Shuotong mirror combined with SMP)and the conventional group(n=49,given conventional lithotripsy).The stone removal effect,surgical indexes and safety were observed.The preoperative and 3 d postoperative inflammatory mediators(interleukin[IL-6],monocyte chemotactic protein-1[MCP-1],C-reactive protein[CRP]),renal function indexes(kidney injury molecule-1[KIM-1],neutrophil gelatinase-associated lipid transport protein[NGAL],and β2-microglobulin[β2-MG])were compared.Results:Postoperatively,the 1-time stone clearance rate of patients in the combined group was higher than that of the conventional group,and the difference was statistically significant(χ2=6.376,P＜0.05).The first time out of bed and hospitalization time of patients in the combined group were shorter than those in the conventional group,and the differences were statistically significant(t=3.562,2.172,P＜0.05).Patients in the combined group had lower CRP,MCP-1,and IL-6 than those in the conventional group,and the difference was statistically significant(t=3.428,3.010,2.135,P＜0.05).Patients in the combined group had lower KIM-1,NGAL,and β2-MG than those in the conventional group,and the difference was statistically significant(t=3.608,3.003,3.440,P＜0.05).The occurrence of complications in patients in the combined group was lower than that in the conventional group,and the difference was statistically significant(χ2=4.356,P＜0.05).Conclusion:Shuotong mirror combined with SMP for the treatment of complex upper ureteral and renal stones optimizes the surgical path,improves short-term efficacy,reduces inflammatory response,helps to protect renal function,and improves therapeutic safety.