Abstract：【Objective】To discuss the injury and recovery of the glomeruli and renal tubule after ureterscopy lithotripsy(URSL). 【Methods】We performed URSL (holmium laser lithotripsy) for 215 patients with ureter stones. The study subjects were divided into the upper ureteral calculi (Group A) and distal ureteral calculi (Group B) according to the position of the stones, as well as the ＜30 min (Group C) and ≥30 min (Group D) according to operation time. By assessing the patients' indicators of urinary microprotein (mALB), N-acetyl-β-glucosaminidase (NAG), retinol binding protein (RBP) before operation and 24 hours, one week, one month, two months after operation, we evaluated the injuries of the glomeruli and renal tubule caused by URSL surgery, and investigated the effects of stone position and operation period on the injury and the injury recovery progress. 【Results】The patients' mALB, NAG, and RBP after operation were significantly above those before the operation (P＜0.01) but then gradually declined after one to two months. The higher the position of the stone and the longer the operation time, the more dramatic the increase of NAG was after operation (P＜0.05). 【Conclusion】Ureterscopy lithotripsy causes injury to both the glomeruli and renal tubule. The injury of renal tubule was more serious when there was a higher stone position and longer operation time. The injury was self-restoring after one to two months after operation.
[1] 郭应禄.周立群主译.坎贝尔-沃尔作泌尿外科学[M].北京:北京大学出版社,2009:3276. [2] 那彦群,孙光主主编.泌尿外科疾病诊断治疗指南[M].北京:人民卫生出版社,2014:191-198. [3] 杜传策,李宏召,任明华,等.输尿管碎石术前后葡萄糖苷酶N-乙酰-β-氨基变化研究[J].中华腔镜泌尿外科杂志,2011,5(5):372-374. [4] 廖松柏,于永刚,武英杰,等. 微创经皮肾镜取石术对肾功能的影响[J].临床外科杂志,2011,19(7):486-487. [5] 叶力克西,王平.早期肾损伤系列临床检测的选择及应用[J],检验医学与临床 ,2008,5(18):1152-1153. [6] 刘定益,陈其智,刘国明,等.体外冲击波碎石对肾小球及肾小管损害的观察[J].中华外科杂志,1994,32(9):570-572. [7] 丁俊.手控灌注在输尿管镜钬激光治疗输尿管上段结石中的应用[J].中国现代医药杂志,2012,14(3):10-11. [8] Savi S,Vukoti V,Lazi M,et al. Management of calculus anuria using ureteroscopic lithotripsy as a first line treatment: its efficacy and safety[J].Urol J,2014,11(2):1392-1399.
2017, Vol. 34 
