A comparative study of ultrasound-guided percutaneous nephrolithotripsy and x-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis

Objective: To compare and analyze the clinical effects of ultrasound-guided percutaneous nephrolithotripsy and X-ray-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi without hydronephrosis.

Methods: Eighty patients with multiple stones without hydronephrosis were admitted at Department of Ultrasound Diagnosis, The first medical center of Chinese PLA General Hospital from January 21, 2020 to December 21, 2020 randomly divided into two groups: experimental group and control group, with 40 cases in each group. Patients in the experimental group were treated with ultrasound-guided percutaneous nephrolithotomy, while those in the control group were treated with X-ray-guided percutaneous nephrolithotomy. The differences in operation time, channel establishment time, channel number, blood loss and stone clearance rate between the two groups were compared and analyzed. Venous blood was drawn before surgery and on the first day after surgery, and serum creatinine, urea nitrogen, blood β2-microglobulin, blood uric acid and other renal indexes were detected. Moreover, renal parenchymal injury was compared between the two groups by renal static imaging, and the incidence of postoperative complications such as pain, fever, urination through incision and injury of surrounding organs were compared and analyzed.

Results: The operation time, channel establishment time, channel number and blood loss in the experimental group were significantly lower than those in the control group, with statistically significant differences (p<0.05). The postoperative renal injury score of the experimental group was 1.03±0.37, which was lower than 1.85±0.63 of the control group (p=0.00); Postoperative Cr, BUN, blood β 2-microglobulin and other indicators in the control group were significantly higher than those in the experimental group, with statistically significant differences (p<0.05). The incidence of peripheral organ injury in experimental group was lower than that in control group, with a statistically significant difference (p=0.04).

Conclusion: Ultrasound-guided percutaneous nephrolithotomy is a safe and effective treatment regimen, boasting various advantages such as real-time monitoring of the surgical process, more accurate and clear channel establishment, avoidance of large vessel injury, shortening of surgical time, alleviation of kidney injury and reduction of surgical complications, which is more advantageous for the treatment of complex renal calculi.