Comparative study of clinical effect of percutaneous nephrolithotomy and flexible ureteroscope lithotripsy in the treatment of renal calculus ≤2 cm / 中国综合临床

ABSTRACT

Objective To compare the effect, postoperative inflammatory response, stress response differences of percutaneous nephrolithotomy ( PCNL) and flexible ureteroscopic lithotripsy ( FURL) in the treatment of renal calculus with a diameter ≤2 cm. Methods One hundred and twenty-eight patients with renal calculus ≤2 cm m in Beijing Pinggu Hospital were enrolled in the study and were randomly divided into PCNL group( 64 cases ) and FURL group ( 64 cases ) . The treatment of PCNL and FURL was carried out respectively. The stone clearance rate,operation time,hospitalization time,the number of painkillers used after surgery,inflammatory index ( hs-CRP,IL-6),oxidative stress index ( MDA,SOD) were compared. Results There was no significant difference in the stone clearance rate between PCNL group and FURL group ( χ2= 0. 208,P>0. 05). The operation time of PCNL group was (55. 32±5. 80) min,which was shorter than that of FURL group ((65. 21± 4. 24) min), the difference was statistically significant ( t = 16. 322,P< 0. 01) . The hospitalization time of FURL group was (4. 50±1. 20) d,which was shorter than that of FURL group ((7. 40 ±1. 80)),the difference was statistically significant (t= 9. 441,P<0. 01). The number of painkillers used after surgery in the FURL group was (0. 35±0. 14) times,which was less than that in FURL group ((0. 85±0. 24) times),the difference was statistically significant ( t = 8. 625,P < 0. 01) . The postoperative hs-CRP of FURL group (10. 62±1. 26) mg was significantly lower than that in PCNL group (19. 42±1. 35) mg/ L,The difference was statistically significant (t= 12. 734,P<0. 01) . The postoperative IL-6 of FURL group was(31. 50±6. 57) ng/ L,significantly lower than the PCNL group(38. 72±6. 25) ng/ L,the difference was statistically significant (t= 5. 839,P<0. 01). The postoperative MDA of FURL group (0. 63±0. 17) mmol/ L was significantly lower than that of the PCNL group (0. 80±0. 20) mmol/ L,The difference was statistically significant (t= 4. 288,P<0. 01) . The postoperative SOD of FURL group (80. 40± 5. 80) U/ L was significantly higher than the PCNL group (74. 30± 7. 40) U/ L, the difference was statistically significant ( t = 4. 691, P <0. 01). The incidence of postoperative complications in PCNL group was 10. 94% ( 7/ 64), FURL group was 2. 17% ( 1/ 64), the difference was statistically significant (χ2 = 4. 800,P<0. 01). Conclusion FURL has the characteristics of less intraoperative blood loss,less trauma,less postoperative pain and fewer complications in the treatment of renal calculus ≤ 2 cm, which has less smaller inflammation, oxidative stress, and conducive to the patients' postoperative recovery.