目的 研究孙氏末段可弯硬性输尿管肾镜治疗复杂性肾结石的效果及对肾功能的影响，为临床治疗提供参考。方法 选 取广东医科大学附属第二医院 2020 年 5 月至 2022 年 4 月接收的 60 例复杂性肾结石患者，按随机数字表法分为对照组和观察组，均 30 例。对照组患者采取经皮肾镜碎石术治疗，观察组患者采取孙氏末段可弯硬性输尿管肾镜治疗。比较两组患者手术相关指标、胱抑素 C （Cys-C）、β2- 微球蛋白（β2-MG）、尿酸（UA）、中性粒细胞明胶酶相关脂质运载蛋白（NGAL）、血管紧张素Ⅰ（Ang Ⅰ）、血管紧 张素Ⅱ（Ang Ⅱ）、超敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子 -α（TNF-α）水平及并发症发生情况。结果 观察组患者手术、排气、 住院时间均显著短于对照组，术中出血量显著少于对照组，结石排净率明显高于对照组（P<0.05）；两组患者治疗后 Cys-C、NGAL、 β2-MG 水平显著高于治疗前，UA 水平显著低于治疗前（P<0.05）；观察组患者治疗后 Cys-C、NGAL、β2-MG、UA 水平均显著低于对照 组（P<0.05）；两组患者治疗后 Ang Ⅰ、Ang Ⅱ、hs-CRP、TNF-α 水平均显著高于治疗前，但观察组显著低于对照组（P<0.05）；观察 组患者并发症发生率显著低于对照组（P<0.05）。结论 孙氏末段可弯硬性输尿管肾镜可有效治疗复杂性肾结石，具有较高的结石排净 率，且对肾功能损伤较小，术后并发症发生风险较低，值得临床应用。
Objective To study the effect of Sun’s end segment flexible ureterorenoscope in the treatment of complex renal calculi and its in?uence on renal function, so as to provide reference for clinical treatment. Methods From May 2020 to April 2022, 60 patients with complex renal calculi admitted to the Second Af?liated Hospital of Guangdong Medical University were selected and divided into the control group and the observation group according to the random number table, with 30 patients in each group. The patients in the control group were treated with percutaneous nephrolithotripsy, and the patients in the observation group were treated with Sun’s end segment ?exible ureterorenoscope. Compare the operation related indexes, cystatin C (Cys-C), β2-microglobulin (β2-MG), uric acid (UA), neutrophil gelatinase-associated lipocalin (NGAL),angiotensinⅠ(AngⅠ),angiotensin Ⅱ (Ang Ⅱ), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor- α (TNF- α) levels and complications. Results The durations of operation, exhaust and hospitalization in observation group were signi?cantly shorter than that in control group, the amount of intraoperative blood loss was signi?cantly less than that in control group, and the stone clearing rate was signi?cantly higher than that in control group (P<0.05). After treatment, the levels of Cys-C, NGAL and β2-MG in two groups were signi?cantly higher than before treatment, while the level of UA was signi?cantly lower than before treatment (P<0.05). The levels of Cys-C, NGAL, β2-MG and UA in observation group were signi?cantly lower than those in control group after treatment (P<0.05). The levels of AngⅠ, Ang Ⅱ, hs-CRP and TNF-α in two groups after treatment were signi?cantly higher than before treatment, but the levels of Ang Ⅰ, Ang Ⅱ, hs-CRP and TNF-α in observation group was signi?cantly lower than that in the control group (P<0.05). The complication rate of observation group was signi?cantly lower than that of control group (P<0.05). Conclusion Sun’s end segment ?exible ureterorenoscope can effectively treat complex renal calculi, with a high stone removal rate, less damage to renal function, and a low risk of postoperative complications, which is worthy of clinical application.