负压吸引MPCNL一期治疗结石性脓肾的应用研究  

A study of minimally invasive percutaneous nephrolithotomy with the aid of a patented suctioning sheath in the treatment of renal calculus complicated with pyonephrosis

作　　者：黄建荣[1] 宋乐明[1] 刘泰荣[1] 杜传策[1] 姚磊[1] 郭树林[1] 钟久庆[1] 叶章群[2] 

机构地区：[1]江西省赣州市人民医院泌尿外科,江西赣州341000 [2]华中科技大学附属同济医院泌尿外科,湖北武汉430030

出　　处：《现代泌尿外科杂志》2015年第11期787-789,共3页Journal of Modern Urology

基　　金：2009年江西省卫生厅重大科技攻关计划课题(No.20094015)

摘　　要：目的探讨微造瘘经皮肾镜负压吸引碎石清石鞘治疗结石性脓肾的价值。方法将182例结石性脓肾患者随机分为观察组(n=91)和对照组(n=91),对照组采用传统的微通道经皮肾镜(MPCNL)治疗,观察组采用经皮肾微造瘘负压吸引碎石清石鞘进行治疗。结果观察组均一期手术治疗,对照组14例行一期造瘘,其余一期取石。观察组并发症发生率为12.1%,明显低于对照组的51.6%;观察组一期清石率为96.7%,对照组73.6%;观察组手术时间(54.5±14.5)min,对照组(70.2±11.7)min;观察组出血量(126.4±47.2)mL,对照组(321.6±82.5)mL;观察组住院天数(6.4±2.3)d,对照组(10.6±3.7)d。以上各项指标比较,观察组效果明显优于对照组(P<0.05)。结论微造瘘经皮肾负压吸引碎石清石鞘在一期治疗结石性脓肾中安全、经济、实用,值得临床推广。Objective To determine if the vacuum-assisted minimally invasive percutaneous nephrolithotomy （MPCNL） is a more effective procedure in the treatment of calculous pyonephrosis. Methods A total of 182 patients with calculous pyonephrosis were randomized into experimental group （n = 91） and control group （n = 91）. The experimental group received MPCNL assisted by vacuum aspiration, and the control group underwent conventional MPCNL. Results All patients in the experimental group had one-stage operation, and 14 patients in the control group underwent nephrostomy. The vacuum-assisted MPCNL was superior to conventional MPCNL in several aspects, including reduced complications （12.1% vs. 51.6 %）, improved one-stage stone clearance rate （96.7% vs. 73.6%）, decreased operation time [（54.5± 14.5） min vs. （70.2 ± 11.7） mini, less hemorrhage [（126.4±47.2）mL vs. （321.6±82.5）mL] and shorter length of stay [（6.4±2.3）days vs. （10.6±3.7） days]. Conclusions Vacuum-assisted MPCNL is a more secure, effective and economical procedure than conventional MPCNL in treating calculous pyonephrosis. It deserves an extensive clinical application due to its benefits in promoting patients recovery, relieving their financial burden and improving the quality of life.

关 键 词：结石性脓肾 负压吸引 负压吸引清石鞘 微通道经皮肾镜(MPCNL) 

分 类 号：R692.4[医药卫生—泌尿科学]