目的 研究输尿管软镜碎石术（RIRS）联合前端可弯曲负压吸引鞘治疗上尿路结石患者疗效及对并发症的影响。方法 选取2024年5月—2025年4月收治的上尿路结石患者60例,按随机数字表法分为观察组与对照组,每组各30例。对照组采用RIRS联合普通输尿管软镜鞘治疗,观察组采用RIRS联合前端可弯曲负压吸引鞘治疗,对比两组患者的结石清除率、疼痛程度[视觉模拟评分法（VAS）评分]、炎症指标[白细胞计数（WBC）、超敏C反应蛋白（hs-CRP）]、应激指标[肾上腺素（E）及去甲肾上腺素（NE）]和并发症发生情况。。结果 观察组结石清除率高于对照组（P<0.05）;术前两组VAS评分对比无明显差异（P>0.05）,术后观察组VAS评分为（4.26±1.26）分,显著低于对照组的（6.36±1.51）分（t=5.849,P<0.05）;术前两组WBC、hs-CRP水平对比均无明显差异（P>0.05）,术后观察组WBC及hs-CRP水平改善幅度显著优于对照组（P<0.05）;术前两组应激反应指标水平对比均无明显差异（P>0.05）,术后观察组应激激素水平低于对照组（P<0.05）;观察组并发症发生率明显低于对照组（P<0.05）。结论 RIRS联合前端可弯曲负压吸引鞘治疗上尿路结石在提高结石清除率、减轻术后疼痛、降低术后炎症和应激反应以及减少术后并发症方面具有显著优势,值得在临床实践中推广应用。

Objective To study the efficacy of retrograde intrarenal surgery （RIRS） combined with front flexible negative pressure suction sheath in the treatment of upper urinary tract calculi. Methods A total of 60 patients with upper urinary tract calculi admitted to our hospital from May 2024 to April 2025 were randomly divided into an observation group and a control group according to random number table method, with 30 cases in each group. The control group was treated with RIRS combined with ordinary flexible ureteroscope sheath, and the observation group was treated with RIRS combined with front flexible negative pressure suction sheath. The stone clearance rate, pain degree [visual analogue scale （VAS） score], inflammatory indicators [white blood cell count （WBC） and high-sensitivity C-reactive protein （hs-CRP）], stress indicators [epinephrine （E） and norepinephrine （NE）], and complication incidence were compared between the two groups. Results The observation group showed a significantly higher stone clearance rate than the control group （P<0.05）. There was no significant difference in VAS score between the two groups before surgery （P>0.05）, but the postoperative VAS score in the observation group [（4.26±1.26） points] was significantly lower than that in the control group [（6.36±1.51） points; t=5.849, P<0.05]. No significant differences were observed in WBC and hs-CRP levels between the two groups before surgery （P>0.05）, but the improvement of WBC and hs-CRP levels in the observation group was significantly larger than that in the control group （P<0.05）. No significant differences were observed in stress indicators between the two groups before surgery （P>0.05）, but the postoperative stress hormone level in the observation group was significantly lower than that in the control group （P<0.05）. The complication incidence in the observation group was significantly lower than that in the control group （P<0.05）. Conclusion RIRS combined with front front flexible negative pressure suction sheath in the treatment of upper urinary tract calculi has significant advantages in improving stone clearance rate, allevating postoperative pain, and reducing postoperative inflammation, stress response, and complications, which is worthy of promoting in clinical practice.