摘要
目的观察经皮肾镜碎石取石术(PCNL)联合负压吸引鞘治疗肾和输尿管上段结石的效果。方法本研究为前瞻性研究,选取2020年3月至2022年5月在兴宁市第三人民医院接受手术治疗的60例肾或输尿管上段结石患者作为研究对象,按抽签法分两组,各30例。对照组、研究组按照PCNL流程分别采用剥皮鞘、负压吸引鞘治疗,比较两组术中肾盂内压、清石时间、一期清石率、总清石率、并发症及手术前后实验室相关指标。结果两组术中肾盂内压[(2.0±0.6)kPa vs(16.6±3.7)kPa]、术后降钙素原[(0.34±0.10)μg/L vs(0.87±0.22)μg/L]、白细胞[(6.04±1.55)×10^(9)/L vs(9.35±2.17)×10^(9)/L]及C反应蛋白水平[(11.56±3.16)mg/L vs(20.35±4.10)mg/L]相比,研究组较低,差异有统计学意义(P<0.05)。两组清石时间[(79±10)min vs(108±22)min]相比,研究组较短,差异有统计学意义(P<0.05)。两组一期清石率(96.67%vs 73.33%)、总清石率(100.00%vs 80.00%)、术后血红蛋白水平[(121±13)g/L vs(103±14)g/L]相比,研究组较高,差异有统计学意义(P<0.05)。两组并发症总发生率相比(3.33%vs 26.67%),研究组较低,差异有统计学意义(P<0.05)。结论PCNL联合负压吸引鞘治疗肾和输尿管上段结石可提高清石效率,降低患者术中肾盂内压,改善术后机体相关指标水平,减少并发症的发生,值得临床推广。
Objective To observe the effects of percutaneous nephrolithotripsy(PCNL)combined with negative pressure suction sheath in the treatment of renal and upper ureteral calculi.Methods Totally 60 patients with renal or upper ureteral calculi surgically treated in our hospital from March 2020 to May 2022 were assigned to two groups by sortition method,with 30 patients in each group in this prospective study.The control group and study group were treated with peel-away sheath and negative pressure suction sheath in addition to PCNL,respectively.The two groups were compared in terms of intra-operative renal pelvic pressure,stone-free time,stone-free rate after the one-stage operation,overall stone-free rate,complications,and laboratory parameters before and after the operation.Results The study group had significantly lower intra-operative renal pelvic pressure[(2.0±0.6)kPa vs(16.6±3.7)kPa],postoperative PCT[(0.34±0.10)μg/L vs(0.87±0.22)μg/L],WBC[(6.04±1.55)×10^(9)/L vs(9.35±2.17)×10^(9)/L]and CRP[(11.56±3.16)mg/L vs(20.35±4.10)mg/L]than the control group(all P<0.05).The study group had a significantly shorter stone-free time than the control group[(79±10)min vs(108±22)min,P<0.05].The study group had a significantly higher stone-free rate(96.67%vs 73.33%)after the one-stage operation,overall stone-free rate(100.00%vs 80.00%),and postoperative HGB level[(121±13)g/L vs(103±14)g/L]than the control group(all P<0.05).The study group had a significantly lower overall incidence of complications than the control group(3.33%vs 26.67%,P<0.05).Conclusions PCNL combined with negative pressure suction sheath in the treatment of renal and upper ureteral calculi increases the stone clearance efficiency,reduces the intra-operative renal pelvic pressure,improves the related postoperative parameters,reduces the incidence of complications,and holds promise for clinical application.
作者
黄日欢
曹浪泉
刘思云
Huang Rihuan;Cao Langquan;Liu Siyun(The Third Hospital of Xingning,Guangdong 514500,China)
出处
《中华腔镜泌尿外科杂志（电子版）》
2023年第1期54-57,共4页
Chinese Journal of Endourology(Electronic Edition)
基金
梅州市社会发展科技计划项目(2019B149)。
关键词
输尿管结石
肾结石
经皮肾镜
负压吸引鞘
剥皮鞘
Upper ureteral calculi
Renal calculi
Percutaneous nephrolithotripsy
Negative pressure suction sheath
Peel-away sheath
