Objective To investigate the effect of minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy on postoperative serum β2-microglobulin (β2-MG), retinol binding protein (RBP) levels and sexual function in patients with complex renal calculi. Methods From October 2013 to October 2016, 93 patients with complex renal calculi in our hospital were selected and were divided into control group (n=46) and observation group (n=47) according to different surgical procedures. The control group was treated with open nephrectomy, while the observation group was treated with minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy. Surgery condition, complications were compared between the two groups, and serum β2-MG, RBP, serum creatinine (Scr) levels before and 1 week after the operation, sexual function score and quality of life score (SF-36) 6 months after the operation were compared. Results Compared with the control group, the operation time of the observation group was prolonged, but the intraoperative blood loss was decreased, the hospitalization time and getting out of bed time were shortened, and the stone clearance rate was improved, with statistically significant differences (P<0.05). There were no statistically significant differences in serum β2-MG, RBP, and Scr levels between the two groups before the operation (P>0.05); compared with the control group, serum β2-MG and Scr levels were decreased in the observation group and serum RBP level was increased at 1 week after the operation, with statistically significant differences (P<0.05). The scores of sexual arousal, sexual desire, orgasm, sexual satisfaction of patients and their spouse, and other sexual function of the observation group were higher than those of the control group at 6 months after the operation, with statistically significant differences (P<0.05). The SF-36 scores of the two groups at 6 months after the operation were higher than those before the operation, and that of the observation group was higher than that of the control group, with statistically significant difference (P<0.05). The incidence of postoperative complications in the observation group [8.51％ (4/47)] was lower than that in the control group [28.26％ (13/46)], with statistically significant difference (P<0.05). Conclusion Minimally invasive percutaneous nephrolithotomy combined with extracorporeal shock wave lithotripsy in the treatment of patients with complex renal calculi has a significant effect, which can significantly improve serum β2-MG, RBP, and Scr levels, improve their renal function and sexual function, reduce the intraoperative bleeding and the incidence of complications, promote patients' rehabilitation, improve their quality of life.%目的 探讨经皮肾镜钬激光碎石联合体外冲击波碎石对复杂性肾结石患者术后血清 β2-微球蛋白(β2-MG)、视黄醇结合蛋白(RBP)水平及性功能的影响.方法 选取2013年10月至2016年10月本院93例复杂性肾结石患者,依据术式不同分为对照组46例、观察组47例.对照组采取开放性肾切开取石治疗,观察组采取经皮肾镜钬激光碎石联合体外冲击波碎石治疗.比较两组手术情况、并发症发生情况,并对比两组术前、术后1周血清 β2-MG、RBP、血肌酐(Scr)水平与术前、术后6个月的性功能评分、生活质量评分(SF-36).结果 与对照组相比,观察组手术时间延长,但术中出血量降低,住院时间与下床活动时间缩短,结石清除率提高,差异均有统计学意义(均P<0.05);术前两组血清β2-MG、RBP、Scr水平比较差异均无统计学意义(均P>0.05),术后1周与对照组相比,观察组血清β2-MG、Scr水平降低,血清RBP水平升高,差异均有统计学意义(均P<0.05);术后6个月观察组性唤起、性欲、性高潮、患者与其配偶性生活满意度等性功能评分均高于对照组,差异均有统计学意义(均P<0.05);术后6个月两组SF-36评分均较术前提高,且观察组高于对照组,差异均有统计学意义(均P<0.05);观察组术后并发症发生率低于对照组[8.51％(4/47)比28.26％(13/46)],差异有统计学意义(P<0.05).结论 予以复杂性肾结石患者经皮肾镜钬激光碎石联合体外冲击波碎石治疗效果显著,可明显改善患者血清 β2-MG、RBP、Scr水平,提高其肾功能及性功能,降低术中出血量及并发症发生率,促进患者术后康复,提高其生活质量.
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