Abstract：Objective:To investigate the effect of percutaneous nephrolithotomy with holmium laser lithotripsy on stress response and renal function of patients with complex renal calculus. Methods:Ninety patients with complex renal calculus were randomly divided into observation group (n=45) and control group (n=45). The patients in observation group underwent percutaneous nephrolithotomy with holmium laser lithotripsy, and those in control group were treated with open renal lithotomy. The operation time, intraoperative blood loss, and postoperative complications in two groups were recorded. The changes in cortisol (Cor), noradrenaline (NE), adrenocorticotrophic hormone (ACTH) and blood urea nitrogen (BUN), serum creatinine (SCr), neutrophil gelatinase-associated lipocalin (NGAL) levels in two groups before and after operation were analyzed. Results:The operative time, activity out of bed days and hospital stay in observation group were significantly shorter than those in control group (P<0.05). One day after operation, the serum Cor, NE, and ACTH levels in two groups were significantly increased as compared with those before operation, and those indexes in control group were significantly higher than in observation group (P<0.05). The serum BUN, SCr and NGAL levels in observation group at 1st week and 1st month after operation were significantly lower than those in control group (P<0.05). The incidence of postoperative complications was significantly lower, and the stone clearance rate was significantly higher in the observation group than in the control group (P<0.05). Conclusions:Percutaneous nephrolithotomy with holmium laser lithotripsy has precise curative effect in the treatment of complex renal calculus. It can reduce the stress response and kidney function injury.
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