Impact of negative pressure aspiration-assisted flexible ureteroscopic laser lithotripsy on renal function and inflammatory levels in patients with upper urinary tract calculi
10.3760/cma.j.cn431274-20250208-00143
- VernacularTitle:负压吸引辅助输尿管软镜激光碎石对上尿路结石患者肾功能和炎症水平的影响
- Author:
Lianqiang CHEN
1
;
Haixing MAI
1
Author Information
1. 锦州医科大学研究生培养基地（中国人民解放军联勤保障部队第三医学中心），北京 100031
- Publication Type:Journal Article
- Keywords:
Upper urinary tract calculus;
Flexible ureteroscope;
Laser lithotripsy;
Negative pressure aspiration
- From:
Journal of Chinese Physician
2025;27(10):1493-1499
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the impact of negative pressure aspiration-assisted flexible ureteroscopic laser lithotripsy on renal function and inflammatory levels in patients with upper urinary tract calculi.Methods:This was a prospective study. A total of 202 patients with upper urinary tract calculi who were scheduled to undergo laser lithotripsy at The Third Medical Center of the Chinese People′s Liberation Army Joint Logistics Support Force from February 2022 to September 2024 were enrolled. According to patients′ willingness, they were divided into the control group ( n=111) and the observation group ( n=91). The control group received flexible ureteroscopic laser lithotripsy, while the observation group received negative pressure aspiration-assisted flexible ureteroscopic laser lithotripsy. The surgical characteristics, stone clearance rate, changes and differences in renal function indexes and inflammatory indexes before and after treatment, as well as clinical efficacy and safety were compared between the two groups. Results:The operation time [76(65, 90)min vs 84(74, 95)min] and hospital stay [7(6, 8)d vs 8(6, 8)d] of the observation group were shorter than those of the control group ( P=0.041, 0.026). There was no significant difference in intraoperative blood loss between the two groups [22(20, 24)ml vs 22(19, 24)ml, P=0.436]. The stone clearance rate of the observation group at 3 days after surgery was higher than that of the control group [48.4%(44/91) vs 34.2%(38/111), P=0.042], while there were no significant differences in stone clearance rates at 1 month and 3 months after surgery between the two groups [90.1%(82/91) vs 85.6%(95/111), P=0.331; 95.6%(87/91) vs 93.7%(104/111), P=0.777]. At 3 days after surgery, the levels of serum creatinine, blood urea nitrogen, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in both groups were higher than those before surgery, while the estimated glomerular filtration rate (eGFR) was lower. However, the levels of serum creatinine [(117.25±9.02)μmol/L vs (120.25±11.07)μmol/L], blood urea nitrogen [(13.21±3.22)mmol/L vs (14.13±3.16)mmol/L], CRP [(31.71±8.50)mg/L vs (34.23±9.01)mg/ml], IL-6 [(23.41±5.77)pg/ml vs (25.65±6.57)pg/ml], and TNF-α [(41.25±9.43)pg/ml vs (44.66±9.63)pg/ml] in the observation group were lower than those in the control group (all P<0.05), and the eGFR level was higher than that in the control group [(66.59±5.59)ml/(min·1.73 m 2) vs (65.12±4.41)ml/(min·1.73 m 2), P<0.05]. The total effective rate of treatment was 87.9%(80/91) and the total incidence of postoperative complications was 9.9%(9/91) in the observation group, while those in the control group were 80.2%(89/111) and 11.7%(13/111) respectively; there were no significant differences between the two groups (all P>0.05). Conclusions:Negative pressure aspiration-assisted flexible ureteroscopic laser lithotripsy has a significant effect in the treatment of upper urinary tract calculi. It can effectively improve the short-term postoperative stone clearance rate, enhance renal function and reduce inflammatory levels, which has important clinical application value.
