To study the efficacy of negative pressure combined with ureteroscopy(NPUR)and ureteroscopic pneumatic lithotripsy(URSL)in the treatment of upper ureteral calculi.

From October 2018 to December 2020, 112 patients with upper ureteral calculi treated in our hospital were randomly divided into observation group (56 cases) and control group (56 cases). The patients in the control group were given NPUR, while the patients in the observation group were given URSL. The operative condition, stone clearance rate, urinary α1-microglobulin, serum cystatin C and complications were compared between the two groups. Univariate and multivariate logistic analysis were used to analyze the independent influencing factors of postoperative systemic inflammatory response syndrome(SIRS).

The operation time in the observation group was significantly lower than that in the control group (P<0.05). After treatment, two groups of patients with urine α1-Microglobulin and serum cystatin C were significantly increased(P<0.05). Univariate analysis showed that there were significant differences in body mass index, preoperative use of immunosuppressants, positive preoperative urine culture, preoperative fever due to calculi, intraoperative urinary opacity and preoperative urinary leukocyte count between the two groups (P<0.05). Logistic regression analysis showed that preoperative fever due to calculi (OR=2.028, 95%CI: 1.081-3.804) and preoperative urinary leukocyte count (OR=1.505, 95%CI: 1.194-1.897) were independent factors affecting the occurrence of SIRS (P<0.05).

NPU and URSL had the same efficacy in stone clearance, urine α1-microglobulin, serum cystatin C and complications, and preoperative stone fever and preoperative urinary leukocyte count were independent risk factors for the occurrence of SIRS.

Ureteral Calculi; Lithotripsy; Ureteroscopy; Systemic Inflammatory Response Syndrome