Comprehensive and continuous nursing strategies in perioperative management of upper urinary tract stones treated with holmium laser lithotripsy.

OBJECTIVE

This research aims to analyze the effects of total, continuous nursing interventions as a perioperative care system for patients undergoing percutaneous nephrolithotripsy (PCNL) with upper urinary tract stones on postoperative: inflammatory response, oxidative stress, and stress hormones.

METHODS

In the study, 150 patients with upper urinary tract stones (renal and proximal upper urinary tract stones) underwent PCNL from January 2023 to December 2024. The patients were then randomly assigned into two groups; the control group (75 patients) received conventional nursing care interventions, and the study group (75 patients) received comprehensive and continuous nursing interventions. Postoperative levels of inflammatory markers (CRP, IL-10), oxidative stress indicators (MDA, SOD), and stress hormones (COR, ACTH, NE) were compared between the two groups. Additionally, the incidence of postoperative complications and length of hospital stay were recorded.

RESULTS

The study group exhibited significantly lower levels of postoperative inflammatory markers compared to the control group (p < 0.05). Improvements in oxidative stress indicators were notable, with a significant reduction in MDA levels and a marked increase in SOD levels (p < 0.05). Furthermore, stress hormone levels (COR, ACTH, NE) in the study group were significantly lower than those in the control group (p < 0.05). The incidence of postoperative complications in the study group (5.56%) was significantly lower than that in the control group (20.83%), with a reduced length of hospital stay and increased patient satisfaction (p < 0.05).

CONCLUSION

The collaborative and continuous nursing strategy almost completely avoids postoperative inflammatory responses, reduces oxidative stress, and regulates the secretion of stress-related hormones, greatly improving recovery outcomes for upper urinary tract stone patients undergoing PCNL.