经皮肾穿刺造瘘后输尿管镜钬激光碎石肾盂内压力变化及临床意义  

Significance and changes of renal pelvic pressure in transureteroscopic lithotripsy with holmium la- ser after percutaneous nephrostomy

作　　者：操作亮[1] 章传华[1] 袁敬东[1] 黄遂斌[1] 段志国[1] 

机构地区：[1]武汉市第一医院泌尿外科,430030

出　　处：《临床外科杂志》2013年第2期106-108,共3页Journal of Clinical Surgery

摘　　要：目的探讨经皮肾穿刺造瘘后输尿管镜钬激光碎石术术中肾盂内压力变化及对术后并发症的影响。方法回顾性分析输尿管镜碎石术治疗上尿路结石64例的临床资料，其中术前行。肾脏穿刺造瘘28例（实验组）；术前未行肾脏穿刺造瘘36例（对照组）。采用压力传感器实时测量行输尿管镜碎石术的患者肾盂内压力，统计术后发热、疼痛指数及肾功能等相关临床指标。结果实验组术中平均肾盂压力（17．4±3．5）mmHg（1mmHg=0．133kPa），对照组为（22．3±5．7）mmHg。实验组术后发热、早期一过性肾功能减退发生率及肾区疼痛均明显低于对照组，差异有统计学意义。结论术前肾造瘘能够降低输尿管镜钬激光碎石术中的肾盂压力及术后的并发症。Objective To research the changes of renal pelvic pressure（RPP）in transuretero- seopic lithotripsy with holmium laser after percutaneous nephrostomy （PCN）and inspect its influence on postoperative complications. Methods A retrospective analysis was reviewed in 64 cases of upper ureteral calculus who underwent transureteroscopic lithotripsy. In the experimental group,28 cases were enrolled and PCN was performed before the lithortripsy;In the control group,36 cases were enrolled and PCN was not performed before surgery. The RPP was measured by baroceptor during the operation, and postoperative implications,including postoperative fever,pain scores and renal function were evaluated statistically. Re- suits The mean RPP of the experimental group and the control group was 17.4 _＋ 3.5 mm Hg and 22.3 -＋ 5.7 mm Hg respectively. The incidence of postoperative fever,renal function decline and pain scores in the experimental group was significantly lower than that in the control group （ P 〈 0.05 ）. Conclusion Preop- erative PCN may reduce the RPP and postoperative complications in the ureteroscopic lithotripsy for ureter- al calculi.

关 键 词：经皮肾穿刺造瘘 肾盂内压 输尿管结石 碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]