经皮肾镜取石术中不同灌注压力对术后患者感染状态及肾功能的影响  

Effects of different perfusion pressures during percutaneous nephrolithotomies on the postoperative infection status and renal functions

作　　者：李晓明[1] 李腾成[2] 杨飞[2] 蔡佳荣[2] 孙其鹏[2] 湛海伦[2] 周祥福[2] 

机构地区：[1]中山大学附属第三医院生殖医学中心,广东广州510000 [2]中山大学附属第三医院岭南医院泌尿外科,广东广州510000

出　　处：《中华医院感染学杂志》2016年第19期4485-4487,共3页Chinese Journal of Nosocomiology

基　　金：广东省自然科学基金资助项目(S2013040014333)

摘　　要：目的研究经皮肾镜取石术中不同灌注压力对于术后患者感染状态及肾功能的影响,为临床上灌注压力的选择提供依据。方法回顾性分析2014年10月-2015年10月在医院行经皮肾镜取石术70例患者临床资料,其中高灌注压力组患者33例,低灌注压力组患者37例,比较两组患者手术前后生命体征、休克指数、血白细胞计数、中性粒细胞百分率、血肌酐浓度等的差异。结果高灌注压力组患者术后24、48、72h的体温、中性粒细胞百分率、血肌酐浓度均高于低灌注压力组,差异有统计学意义(P<0.05);高灌注压力组患者术后24、48h休克指数高于低灌注压力组,差异有统计学意义(P<0.05),而术后72h两组患者休克指数差异无统计学意义;两组患者术后24、48、72h脉率、收缩压、血白细胞计数差异均无统计学意义。结论高灌注压力组患者术后体温、中性粒细胞百分率、血肌酐浓度、休克指数均高于低灌注压力组,即高灌注压力组患者术后感染状态更加严重,肾功能损害也相对严重,而术后72h两组患者的休克指数相比差异无统计学意义,这说明随着术后补液、抗感染等治疗措施的实施,患者感染减轻,逐渐好转。OBJECTIVE To investigate the effects of different perfusion pressures during percutaneous nephrolithotomies on the postoperative infection status and renal functions,so as to provide evidence for the clinical selection of perfusion pressure.METHODS A total of 70 patients treated with PCNL in our hospital from Oct.2014 to Oct.2015 were retrospectively analyzed,and divided into two groups,including 33 patients in high perfusion pressure group,and the other 37 patients in low perfusion pressure group.Vital signs,shock index,leukocyte count,neutrophil percentage and serum creatinine were analyzed to draw a conclusion.RESULTS Temperature,neutrophil percentage,serum creatinine of high perfusion pressure group were significantly higher than those of low perfusion pressure group after operation of 24 h,48hand 72h（P〈0.05）.Shock index of high perfusion pressure group was significantly higher than that of low perfusion pressure group after operation of 24 h,48hand 72h（P〈0.05）.Shock indexes after operation of 24 hand 48hwere significant different（P〈0.05）,however,there was no significant difference after 72 h.Sphygmus,systolic blood pressure and leukocyte count had no statistically significant difference of the two groups after operation of 24 h,48hand 72 h.CONCLUSIONThe temperature,neutrophil percentage,serum creatinine and shock index of high perfusion pressure group were higher than those of low perfusion pressure group,which means the infection status is more serious,and the renal function damage is also relatively serious.The difference of the shock index had no significance after 72 h,which means the patients gradually improved with the fluid infusion and anti-infection treatments.

关 键 词：肾结石 经皮肾镜取石术 灌注压力 尿路感染 肾功能 

分 类 号：R693.4[医药卫生—泌尿科学]