Clinical Application Of PCNL Combined With RIRS In The Treatment Of Complex Upper Urinary Calculi

Objective The purpose of this study was to investigate the efficacy and safety of PCNL combined with RIRS in the treatment of complicated upper urinary tract calculi compared with PCNL alone.Methods 40 patients with complex upper urinary calculus admitted to the department of Urology in the General Hospital of Ningxia Medical University from June 2018 to September2020 were randomly selected as the subjects of this study.They were divided into ECRIS group(n=20)and PCNL group(n=20).The PCNL group was treated with percutaneous nephrolithotripsy combined with pneumatic lithotripsy,and the ECRIS group adopted the treatment of ultrasonic-location single-channel percutaneous nephrolithotripsy combined with flexible ureteroscope holmium laser lithotripsy.After the collection of samples,SPSS 23.0software was used to compare the specific indicators of patients in the 2 groups,the measurement data was expressed as((?) ±S),t test was used for comparison between the independent groups,and the χ2 test was used for comparison of enumeration data.P<0.05 was considered statistically significant.The removing stone rate,operation time,hospital stay time after operation and the hemoglobin were compared.Results(1)Compared with 55.0%(15/20)in patients receiving percutaneous nephroscopy alone,the net stone rate 90.0%(18/20)in patients receiving dual endoscopic combined surgery was significantly higher,and there was a statistical difference between the two groups(P<0.05);(2)There was a significant difference in operative time between the two groups(118.10±46.17)min and(68.75±28.83)min,and a significant difference existed in the two groups(P<0.05);(3)In terms of the length of hospital stay after surgery,the length of hospital stay of patients receiving dual endoscopic surgery was obviously shorter than that of patients receiving percutaneous nephrolithoscopy alone(5.05±0.945)d,and there was a statistically significant difference between the two groups(P<0.05);(4)In terms of the Antibiotic use time after surgery,there was significant difference in the two group(3.15± 0.49)d between the patients who received the dual-lens combined surgery and those who received percutaneous nephroscopy alone(4.20±0.83)d,and there was statistically significant difference between the two groups(P<0.05);(5)Whether a second operation was needed,0%(0/20)of the patients who received dual endoscopic combined surgery and 40.0%(8/20)of the patients who received percutaneous nephrolithoscopy alone showed a statistically significant difference between the two groups(P<0.05).Conclusion The main advantages of the combination of double endoscopy are less postoperative complications,lower residual rate of stones,shorter postoperative hospital stay and higher stone clearance rate after one operation.