Comparative Study On The Intraoperative Effects And Therapeutic Effects Of Preoperative Percutaneous Nephrostomy And Preoperative Ureteral Stent Placement On Upper Urinary Tract Obstruction With Infection In The Later Stage

Objective:The objective of this study was to compare the intraoperative effects and postoperative efficacy of Percutaneous nephrostomy(PCN)and Retrograde ureteral stenting(RUS)on obstructive stones of the upper urinary tract.Translation:A retrospective study was conducted on 34 patients who received PCN treatment before undergoing ureteroscopic lithotripsy in the urology department of the China-Japan Friendship Hospital of Jilin University from November 2020 to September 2022.Another 34 patients who received RUS treatment before undergoing ureteroscopic lithotripsy were selected as the B group.Clinical data before and after surgery were collected for both groups,and statistical methods such as t-test and χ~2 test were used for data analysis.General information such as patient age,gender,and stone diameter,as well as clinical data such as preoperative peripheral blood white cell count,preoperative peripheral blood neutrophil percentage,surgical duration,postoperative peripheral blood white cell count on the first day,postoperative peripheral blood neutrophil percentage on the first day,postoperative peripheral blood hemoglobin content,and stone clearance rate after two months were compared to analyze the intraoperative effects and postoperative efficacy differences of the two treatment methods for upper urinary tract obstructive stones.Result:By comparing the general data of age,gender,maximum stone diameter,preoperative peripheral blood white cell count,and preoperative peripheral blood neutrophil percentage between the A group and the B group,it can be concluded that there is no significant difference between the two pyelostomy methods for patients with upper urinary tract obstructive stones(P>0.05).However,preoperative percutaneous nephrostomy(PCN)and retrograde ureteral stenting(RUS)can both reduce the incidence of postoperative complications,but PCN can more quickly reduce postoperative inflammatory indicators,significantly reduce the risk of infection(P<0.05),and reduce the operation time(P<0.05),thereby improving the safety of the operation.However,for anemic patients and those with a higher risk of bleeding,RUS has a lower risk of bleeding(P<0.05),making it safer for anemic and high-risk bleeding patients.Conclusion:For routine patients,PCN is a preferred pyelostomy method for controlling infection and improving surgical safety.It has a lower risk of postoperative infection,shorter operation time,and higher surgical safety.For anemic and high-risk bleeding patients,it is recommended to perform RUS to reduce renal pelvis pressure.