Objective To explore the effect of Shuotongscope and ureteroscopy on the treatment of upper urinary tract stones combined with pyogenic kidney on clearing rate, urosepsis and T lymphocyte subsets. Methods From January 2018 to December 2019, 102 patients with upper urinary tract stones combined with pyogenic kidneys were selected and divided into 2 groups according to random number table method, 51 cases in each group. Both groups underwent renal puncture and drainage of pus and antibacterial treatment under the guidance of B ultrasound before operation. After controlling the inflammation, the Shuotongscope group was given the Shuotongscope holmium laser lithotripsy, and the ureter soft mirror group was given the ureter soft mirror holmium laser lithotripsy. The operation time, postoperative hospital stay, success rate of sheath insertion, stone removal rate at 1 d and 1 month after operation, inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] levels, T-lymphocyte subsets (CD3+, CD4+, CD4+/CD8+), renal function indexes [urinary α1 microglobulin (α1-MG), blood urea nitrogen (BUN), blood creatinine (SCr), serum cystatin C (Cys-C), glomerular filtration rate (GFR)], complications of the two groups were compared. Results The operation time of the Shuotongscope group was longer than that of the flexible ureteroscope group (P<0.05). The stone clearing rate (84.31%) on the 1st postoperative day of the Shuotongscope group was higher than that of the flexible ureteroscope group (66.67%) (P<0.05). The stone removal rate (96.08%, 92.16%) of the two groups after 1 month of operation was not statistically significant. CRP, IL-6 and TNF-α in the Shuotongscope group were lower than those in the flexible ureteroscope group at 6 h and 24 h after operation (P<0.05). The number of CD3+, CD4+, CD4+/CD8+ in the Shuotongscope group was higher than that in the flexible ureteroscope group at 6 h and 24 h after operation (P<0.05). There was no significant difference in α1-MG, BUN, SCr, Cys-C, and GFR between the two groups before operation and 2 weeks after operation. There was no statistically significant difference in the total incidence of complications (1.96%, 5.88%) between groups. Conclusions Shuotongscope and flexible ureteroscope are safe and effective in treating upper urinary tract stones with pyogenic kidney, but the early stone clearing rate after Shuotongscope is higher, and it can improve the perioperative inflammatory reaction and body cellular immunity.
Key words
Shuotongscope; /
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Flexible ureteroscope; /
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Upper urinary tract stones; /
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Pyogenic kidney /
Clear stone rate; /
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Urinary sepsis; /
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T lymphocyte subsets
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