摘要
Abstract
Objective:To investigate the clinical efficacy of suction ureteral access sheath(S-UAS)combined with retrograde intrarenal surgery(RIRS)in the treatment of 2-3 cm upper urinary tract calculi.Method:The clinical data of 98 patients with 2-3 cm upper urinary tract calculi admitted to Yangzhou Hongquan Hospital from October 2022 to January 2025 were retrospectively selected.According to the surgical methods,they were divided into S-UAS+RIRS group(48 cases,treated with S-UAS combined with RIRS)and the percutaneous nephrolithotomy(PCNL)group(50 cases,treated with PCNL).The operation related indicators,stone-free rate(SFR),protein-bound uremic toxins(PBUT)and metabolic index levels were compared between the two groups,and the incidence of complications in the two groups was counted.Result:The operation time of S-UAS+RIRS group was longer than that of PCNL group,and the length of hospital stay was shorter than that of PCNL group,the intraoperative blood loss,the decrease in Hb 1 day after the operation compared to before the operation,the increase in WBC,CRP,procalcitonin(PCT)1 day after the operation compared to before the operation,and the VAS score 1 day after the operation were lower than those of the PCNL group(P<0.05).There were no significant differences in SFR between the two groups at 1 day and 1 month after operation(P>0.05).One month after operation,the levels of indoxyl sulfate(IS)in the urine and urinary citrate in the two groups were higher than those before operation,and those in the S-UAS+RIRS group were higher than those in the PCNL group(P<0.05).One month after operation,the levels of uric acid and urinary oxalic acid in the two groups were lower than those before operation,and the levels in S-UAS+RIRS group were lower than those in PCNL group(P<0.05).One month after operation,the 3-indolylacetic acid(IAA)and p-cresyl sulfate(PCS)in the urine in the two groups were lower than those before operation(P<0.05),but there were no significant differences between the two groups(P>0.05).The incidence of complications in S-UAS+RIRS group was lower than that in PCNL group(P<0.05).Conclusion:S-UAS combined with RIRS in the treatment of 2-3 cm upper urinary tract calculi has the same effect as PCNL,and has the advantages of less intraoperative bleeding,faster postoperative recovery and fewer complications.At the same time,it has significant advantages in improving the level of PBUT and metabolic indicators,and is a safe and effective minimally invasive treatment option.关键词
头端可弯曲负压吸引鞘/逆行输尿管软镜手术/经皮肾镜取石术/上尿路结石/尿液蛋白结合毒素/结石清除率Key words
Suction ureteral access sheath/Retrograde intrarenal surgery/Percutaneous nephrolithotomy/Upper urinary tract calculi/Protein-bound uremic toxins/Stone-free rate分类
医药卫生
