输尿管镜碎石术中反流的研究  

Research of reflux during the surgery of ureteroscopic lithodialysis

作　　者：沈志杰[1] 邵怡[1] 鲁军[1] 孙晓文[1] 韩邦旻[1] 刘海涛[1] 夏术阶[1] 

机构地区：[1]上海交通大学附属第一人民医院泌尿外科,上海200080

出　　处：《中国内镜杂志》2008年第12期1245-1248,共4页China Journal of Endoscopy

基　　金：上海市卫生局青年项目(2007Y21)

摘　　要：目的测定输尿管镜碎石术中肾盂反流的情况以及手术对肾脏、肾周情况的影响。方法对75例上尿路结石患者行输尿管镜碎石术,研究不同灌注压力、输尿管镜在不同位置、结石大小、灌注液量、手术时间等因素与肾周情况、手术前后血常规、血液生化变化等之间的关系,探讨输尿管镜碎石术中反流发生的因素。结果患者手术后RBC、Hb、Hct等指标明显低于术前(P<0.01);术后Scr、Na+、Cl-等指标明显高于术前,而K+明显低于术前(P<0.01);9例(12%)患者术后B超出现肾周积液,其中输尿管上段结石8例,中段结石1例;3例术后高热患者均存在不同程度的积液;有肾周积液的患者术中灌注液应用总量[(5866.67±964.37)mL]及手术时间[(59.44±15.09)min],明显高于无肾周积液患者的(2847.12±1202.51)mL和(35.23±10.10)min(P<0.01);术后肾周积液出现与结石大小无明显相关性(P=0.80)。结论输尿管镜碎石术中存在肾盂内尿液反流现象,反流的发生与灌注液用量、手术时间、结石部位有关,与结石大小无明显关系。【Objective】To evaluate the reflux during the surgery of ureteroscopic lithodialysis.【Methods】75 pa-tiens(average age 53 years),41 males and 34 females,were underwent ureteroscopic lithodialysis in our department.Blood routine,serum creatine concentration and electrolytes were measured before and after surgery.All patients were examed with B type ultrasound after surgery by one senior doctor.【Results】The RBC,Hb,Hct and potassium concentration were significantly decreased,while the serum creatine,sodium and c...

关 键 词：输尿管镜 并发症 肾周积液 B超 

分 类 号：R699[医药卫生—泌尿科学]