不同口径通道对经皮肾镜取石手术患者术后感染的影响  

Effect of different caliber channels on postoperative infection in patients with percutaneous nephrolithotripsy

作　　者：洪涛[1] 柯莽[1] 俞洪元[1] 蔡永健[1] 张显军[1] HONG Tao KE Mang YU Hong-yuan CAI Yong-jian ZHANG Xian-jun(Taizhou Hospital of Zhejiang Province, Linhai, Zhejiang 317000, China)

机构地区：[1]浙江省台州医院泌尿外科,浙江临海317000

出　　处：《中华医院感染学杂志》2017年第7期1568-1571,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅医药科技计划项目(2015Z9273)

摘　　要：目的探讨不同口径通道对经皮肾镜取石手术患者术后感染的影响,为临床治疗提供参考依据。方法选取2010-2015年医院进行治疗的肾结石患者418例,按照随机数字表法将患者分为标准通道组与微通道组,各209例;标准通道组采用球囊扩张法建立F24通道,微通道组采用筋膜扩张法建立F16通道;比较两组患者临床指标。结果标准通道组肾结石患者的手术时间、住院时间、术中肾盂内压、术后发热率均明显低于微通道组,差异有统计学意义(P<0.05);标准通道组肾结石患者的结石清除率为98.6%显著高于微通道组79.9%,标准通道组肾结石患者的术后感染率7.2%明显低于微通道组24.9%,差异均有统计学意义(P<0.01);共分离出75株病原菌,以革兰阴性菌为主,共65株占86.7%。结论对肾结石患者而言,采用标准通道进行经皮肾镜取石术的手术时间短、术中出血量无差异、住院时间短、术中肾盂内压小、结石清除率高、感染率低,值得临床推广。OBJECTIVE To investigate the effect of different caliber channels on postoperative infection in patients undergoing percutaneous nephrolithotripsy, so as to provide references for clinical treatment. METHODS A total of 418 cases of patients with kidney stones from Jan. 2010 to Dec. 2015 in our hospital for treatment were select- ed, and were randomly divided into standard channel group and micro channel group according to random number table method, with 209 cases in each group. Patients in standard channel group used balloon dilation to build the F24 channel, and micro channel group used fascia expansion method to build the F16 channel. The clinical indexes of the two groups were compared. RESULTS The operation time, length of stay, intraoperative renal pelvic pres- sure, and postoperative fever rate of patients in standard channel group were significantly lower than those in mi- cro channel group （P〈0.05）. The renal calculi clearance rate of standard channel group was 98.6 %, which was significantly higher than 79.9 % of micro channel group, the postoperative infection rate of standard channel group was 7.2%, which was significantly lower than 24.9% of micro channel group （P〈0.01）. A total of 75 patho- gens were isolated, which were mainly 65 strains of gram-negative bacteria, accounting for 86.7%. CONCLUSION For patients with kidney stones, percutaneous nephrolithotomy with standard channel has shorter operation time, no difference in intraoperative blood loss, shorter hospitalization time, lower intraoperative pelvic pressure, higher stone clearance rate and lower infection rate, which is worthy of promotion.

关 键 词：通道 经皮肾镜取石手术 感染 肾结石 

分 类 号：R619.3[医药卫生—外科学]