Study on the application of percutaneous nephrolithotripsy assistedpneumatic lithotripsy combined with ureteral stent drainage in the treatment of upper urinary tract calculi with severe hydronephrosis
Cheng Cong
Xu Kailiang
Zeng Jinmin
Zhou Jiajie
Liao Yixiang
Abstract：Objective:Exploring the application of percutaneous nephrolithotripsy assisted pneumatic lithotripsy(PL)combined with ureteral stent drainage in upper urinary tract calculi(UUTC)with severe hydronephrosis.Method:84 patients with severe hydronephrosis and UUTC admitted to the department of urology in our hospital from January 2019 to January 2023 were randomly divided into control group(n=42)and observation group(n=42)using a random number table method.The control group received holmium laser lithotripsy combined with ureteral stent drainage,while the observation group received nephroscopy assisted PL combined with ureteral stent drainage.The surgical parameters,renal related factors(urinary endothelin 1(ET-1),aquaporin-1(AQP-1),serum endothe-lial cell specific molecule-1(ESM-1)),primary stone removal and complication rate were compared between the two groups.Result:There was no difference in the comparison of hospitalization time between the two groups(P>0.05).The observation group had a longer surgical time than the control group,but lithotripsy time,intraoperative blood,and postoperative hematuria duration were significantly lower than the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of ET-1,AQP-1,and ESM-1 between the two groups of patients before surgery(P>0.05).However,the above factors were significantly reduced in both groups after surgery,and there were statistically significant in the levels of ET-1[(15.44±2.26)vs.(18.31±2.58)ng/L],AQP-1[(29.35±3.67)vs.(31.48±3.74)ng/L]and ESM-1[(0.77±0.14)vs.(1.15±0.16)ng/ml]between the observation and control group(P<0.05).There was no statistically significant difference in the primary stone removal rate between the two groups(88.10%vs.90.48%)(P>0.05),while the total complication-srateof the observation groupwas significantly lower than that of the control group(4.76%vs.21.43%),with a statis-tically significant difference(P<0.05).Conclusion:Percutaneous nephrolithotripsy assisted PL combined with ure-teral stent drainage has a significant clinical effect in UUTCpatients with severe hydronephrosis,and is worthy of pro-moting.
Keywords：urinary tract calculushydronephrosisnephrolithotomypercutaneousureter
Publication Date：2023-10-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 293-297 )