Effect of percutaneous nephrolithotomy with holmium laser lithotripsy on stress response and renal function of patients with complex renal calculus

Wu Wei; Jiang Juan; Lyu Lei; Xiang Wei; Yuan Jingdong; Zhou Gaofeng

doi:10.19558/j.cnki.10-1020/r.2018.02.005

Abstract：Objective:To investigate the effect of percutaneous nephrolithotomy with holmium laser lithotripsy on stress response and renal function of patients with complex renal calculus.Methods:Ninety patients with com-plex renal calculus were randomly divided into observation group(n=45)and control group(n=45).The pa-tients in observation group underwent percutaneous nephrolithotomy with holmium laser lithotripsy,and those in control group were treated with open renal lithotomy.The operation time,intraoperative blood loss,and postoper-ative complications in two groups were recorded.The changes in cortisol(Cor),noradrenaline(NE),adrenocorti-cotrophic hormone(ACTH)and blood urea nitrogen(BUN),serum creatinine(SCr),neutrophil gelatinase-asso-ciated lipocalin(NGAL)levels in two groups before and after operation were analyZed.Results:The operative time, activity out of bed days and hospital stay in observation group were significantly shorter than those in control group(P<0.05).One day after operation,the serum Cor,NE,and ACT H levels in two groups were significantly increased as compared with those before operation,and those indexes in control group were significantly higher than in observation group(P<0.05).The serum BUN,SCr and NGAL levels in observation group at 1st week and 1st month after opera-tion were significantly lower than those in control group(P<0.05).The incidence of postoperative complications was significantly lower,and the stone clearance rate was significantly higher in the observation group than in the control group (P<0.05).Conclusions:Percutaneous nephrolithotomy with holmium laser lithotripsy has precise curative effect in the treatment of complex renal calculus.It can reduce the stress response and kidney function injury.