“双负压系统”在经皮肾镜碎石取石术中的应用  

Application of“dual negative pressure system”in percutaneous nephrolithotomy

作　　者：封凯文 戴政 朱进[1] 周毅彬[1] 阳东荣[1] 薛波新[1] 单玉喜[1] Feng Kaiwen;Dai Zheng;Zhu Jin;Zhou Yibin;Yang Dongrong;Xue Boxin;Shan Yuxi(Department of Urology,the Second Affiliated Hospital of Suzhou University,Suzhou 215004,China)

机构地区：[1]苏州大学附属第二医院泌尿外科,苏州215004

出　　处：《微创泌尿外科杂志》2022年第4期221-223,共3页Journal of Minimally Invasive Urology

基　　金：江苏省医学重点人才基金(QNRC2016875)

摘　　要：目的:探讨负压清石鞘联合EMS超声组成的双负压系统在经皮肾镜碎石取石术中的临床应用价值。方法:回顾性分析2018年8月至2021年9月间,采用负压清石鞘联合EMS超声碎石系统行经皮肾镜碎石取石术的138例患者的临床资料,记录清石时间、结石清除率、血红蛋白下降水平、肌酐、术后住院时间、术后发热、出血、脓毒血症等并发症发生的情况。结果:手术均获得成功,结石直径2.0~6.4cm,平均3.6cm,清石时间10~63min,平均35min。术后住院时间5~14d,平均5.9d。术后四天结石清除率为92.0%(127/138),术后发热8例(5.8%),无脓毒血症发生。术中均无严重出血,2例患者拔除造瘘管后出血,行数字减影血管造影介入栓塞止血治愈。结论:经皮肾镜碎石取石术中使用负压清石鞘联合EMS超声组成的双负压系统,可提高清石效率,保持肾盂内低压,减少术后感染,不增加费用,值得推广。Objective:To evaluate the safety and efficacy of a dual negative pressure system(DNPS)which consists of a negative pressure sheath and a ultrasonic lithotripsy device in percutaneous nephrolithotomy(PCNL).Methods:A total of 138 patients received PCNL with the DNPS from August 2018 to September 2021.The clinical data including operating time,stone free rate(SFR),hemoglobin decrease,creatinine change,postoperative hospital stay,fever,bleeding,and urosepsis were recorded.Results:All procedures were performed successfully.Mean stone diameter was 3.6 cm(2.0-6.4 cm).Mean operating time was 35 min(10-63 min).mean postoperative hospital stay was 5.9d(5-14 d).The four-day postoperative SFR was 92.0%(127/138).Postoperative fever occurred in 8 patients(5.8%).No urosepsis or severe intraoperative hemorrhage occurred.Bleeding occurred in 2 patients after removing of the nephrostomy tube,which were both cured by embolization of the corresponding renal artery branches.Conclusion:The application of DNPS in PCNL can improve efficiency of stone clearance,maintain low renal pelvic pressure during operation,reduce the chance of postoperative infection,and is cost-effective.The DNPS deserves further clinical application.

关 键 词：肾镜取石 经皮 肾结石 

分 类 号：R699.2[医药卫生—泌尿科学]