The Therapeutic Effect of HLL Under Continuous Irrigation of Epidural Catheter in Ureteral Calculi with High CT Value

doi:10.7517/issn.1674-0475.200519

Abstract

Abstract: The aim of this research is to explore the therapeutic effect of holmium laser lithotripsy (HLL) under continuous irrigation by epidural catheter in the treatment of ureteral calculi of high CT value. A total of 106 patients with ureteral calculi of high CT values were divided into two groups by random number table. The control group adopted HLL under ureteroscopy, and the observation group adopted HLL under continuous irrigation by epidural catheter. The operation time of the observation group was shorter than that of the control group, while the success rate of lithotripsy was higher than that of the control group, and the rate of stone uplift and in vitro lithotripsy was lower than that of the control group (P<0.05). One day after surgery, the adrenaline (AE), cortisol (Cor), and malondialdehyde (MDA) of the observation group were lower than those of the control group, while the superoxide dismutase (SOD) was higher than that of the control group. Three days after surgery, the interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α) and IL-6 in the observation group were lower than those in the control group (P<0.05). The incidence of complications in the observation group (3.77%) was significantly lower than that in the control group (15.09%). It is suggested that HLL under continuous irrigation by epidural catheter is more effective in treating ureteral calculi of high CT value.

Key words: epidural catheter, holmium laser, high CT value, ureteral calculi, renal function, stress response, lithotripsy rate

LIU Qiang, SHAO Jinghui, ZANG Hongxue, LI Shuaibiao. The Therapeutic Effect of HLL Under Continuous Irrigation of Epidural Catheter in Ureteral Calculi with High CT Value[J]. Imaging Science and Photochemistry, 2020, 38(6): 1070-1075.

References

[1] Li J, Yu H, Zhou P, et al. Application of flexible ureteroscopy combined with holmium laser lithotripsy and their therapeutic efficacy in the treatment of upper urinary stones in children and infants[J]. Urology Journal, 2019, 16(4):343-346.
[2] Teng J F, Wang K, Ai X. Comments on thermal effect of holmium laser lithotripsy under ureteroscopy[J]. Chinese Medical Journal (English), 2020, 133(1):86-87.
[3] Chen S, Zhou L, Wei T, et al. Comparison of holmium:YAG laser and pneumatic lithotripsy in the treatment of ureteral stones:an update meta-analysis[J]. Urologia Internationalis, 2017, 98(2):125-133.
[4] Scarpa R M, Scoffone C M, Cracco C M. Letter about:treatment for residual stones using flexible ureteroscopy and holmium laser lithotripsy after the management of complex calculi with single-tract percutaneous nephrolithotomy[J]. Lasers in Medical Science, 2018, 33(2):451.
[5] Secker A, Rassweiler J, Neisius A. Future perspectives of flexible ureteroscopy[J]. Current Opinion in Urology, 2019, 29(2):113-117.
[6] Knudsen B E. Laser fibers for holmium:YAG Lithotripsy:what is important and what is new[J]. Urologic Clinics of North America, 2019, 46(2):185-191.
[7] 王健宇, 胡宗阳, 陶朝发, 等. 经尿道输尿管镜下钬激光碎石术治疗输尿管结石的临床疗效观察[J]. 局解手术学杂志, 2018, 27(1):50-52.
[8] Tracey J, Gagin G, Morhardt D, et al. Ureteroscopic high-frequency dusting utilizing a 120-W holmium laser[J]. Journal of Endourology, 2018, 32(4):290-295.
[9] Aldoukhi AbH, Roberts WbW, Hall TbL, et al. Watch your distance:the role of laser fiber working distance on fragmentation when altering pulse width or modulation[J]. Journal of Endourology, 2019, 33(2):120-126.
[10] 孙乾. 输尿管结石CT值与输尿管镜下钬激光碎石术难易程度相关性分析[D]. 太原:山西医科大学, 2018.
[11] Wang X K, Jiang Z Q, Tan J, et al. Thermal effect of hol-mium laser lithotripsy under ureteroscopy[J]. Chinese Me-dical Journal (English), 2019, 132(16):2004-2007.
[12] Ulker V, Cakmak O, Yucel C, et al. The efficacy and safety of bilateral same-session ureteroscopy with holmium laser lithotripsy in the treatment of bilateral ureteral stones[J]. Minerva Urologica E Nefrologica, 2019, 71(2):174-180.
[13] Wollin D A, Carlos E C, Tom W R, et al. Effect of laser settings and irrigation rates on ureteral temperature during holmium laser lithotripsy, an in vitro model[J]. Journal of Endourology, 2018, 32(1):59-63.
[14] 付焕明, 付艳鹏, 祁进伟, 等. 硬膜外导管和硬膜外穿刺针在输尿管镜下钬激光碎石术中的应用价值[J]. 临床医药文献电子杂志, 2015, (10):1848.
[15] Poggetti A, Del Chiaro A, Nicastro M, et al. A local anesthesia without tourniquet for distal fibula hardware removal after open reduction and internal fixation:the safe use of epinephrine in the foot. A randomized clinical study[J]. Journal Biological Regulators and Homeostatic Agents, 2018, 32(6 Suppl.1):57-63.
[16] 何俊. 腹腔镜下肾部分切除术治疗肾肿瘤对患者血清皮质醇和炎症因子的影响[J]. 国际泌尿系统杂志, 2018, 38(2):195-198.
[17] Yin Y, Han W, Cao Y. Association between activities of SOD, MDA and Na⁺-K⁺-ATPase in peripheral blood of patients with acute myocardial infarction and the complication of varying degrees of arrhythmia[J]. Hellenic Journal of Cardiology, 2019, 60(6):366-371.
[18] 徐小涵, 唐贤富, 郑兴明, 等. 三种微创术式治疗对嵌顿性输尿管上段结石患者肾功能、血清CAT、GSH-Px、MDA、ROS水平及炎症因子水平的影响[J]. 微创泌尿外科杂志, 2019, 8(2):48-52.
[19] 王征球, 龚建涛, 杨晓军, 等. 经内镜逆行胰胆管造影术治疗高龄胆总管结石患者的疗效、安全性及对炎症反应的影响分析[J]. 中国中西医结合消化杂志, 2019, 27(2):19-22.
[20] 王飞, 张宇, 陈乐仲, 等. 微通道经皮肾镜与逆行输尿管软镜碎石治疗对2~4 cm肾结石患者血清炎性因子的影响[J]. 实用医学杂志, 2018, 34(16):2716-2721.
[21] 陈伟栋, 张燕敏, 熊飞, 等. 排石冲剂对草酸钙肾结石大鼠p47 phox和TGF-β1表达的影响[J]. 医药导报, 2019, 38(9):1173-1178.
[22] 秦明, 黄涛, 王献魁. ERCP联合LC对胆囊结石并胆总管结石的疗效及对炎症因子水平的影响[J]. 中国现代普通外科进展, 2018, 21(2):136-137, 140.