负压吸引鞘在斜仰截石位经皮肾镜中的应用  

Negative pressure suction sheath for minimally invasive percutaneous nephrolithotomy in oblique supine position

作　　者：习明[1] 郑秋平[1] 华伟[1] 万颂 江文聪 刘远灵[1] 邓广鹏[1] 曾昭昌 周宇林[1] Xi Ming;Zheng Qiuping;Hua Wei;Wan Song;Jiang Wencong;Liu Yuanlin;Deng Guangpeng;Zeng Zhaochang;Zhou Yulin(Department of Urology,Huadu Poeple's Hospital Affiliated to Southern Medical University,Guangzhou 510800,China)

机构地区：[1]南方医科大学附属花都区人民医院泌尿外科

出　　处：《中华腔镜泌尿外科杂志（电子版）》2019年第4期255-258,共4页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨负压吸引鞘在斜仰截石位微创经皮肾镜碎石取石术(MPCNL)中治疗复杂性肾结石的安全性、有效性。方法对我院2017年1月至2018年12月住院期间的440例肾结石患者,按入院顺序的单双号随机分为观察组、对照组,每组220例,观察组行负压吸引鞘结合斜仰截石位下MPCNL,对照组行常规俯卧位及单孔鞘(常压鞘)MPCNL。记录每组的手术时间、结石取尽率、出血量、术中术后并发症等资料,回顾分析并比较两组的临床资料。结果观察组结石取尽率高于对照组(P<0.05),手术时间、术中出血量、术后并发症发生率、术后发热发生率、术后第1天降钙素原(PCT)值、C反应蛋白(CRP)值明显低于对照组(P<0.05)。结论负压吸引鞘在斜仰截石位MPCNL中安全性高、并发症少、结石取尽率高,且斜仰截石位无需变换体位行经尿道逆行输尿管插管。Objective To investigate the safety and clinical efficacy of negative pressure aspiration sheath combined with minimally invasive percutaneous nephrolithotomy(MPCNL)in oblique supine position for complex renal calculi.Methods 440 patients with renal calculus in our hospital from January 2017 to December 2018 were randomly divided into two groups:observation group and control group,220 cases in each group.Patients in the observation group underwent MPCNL with negative pressure suction sheath in oblique supine position,while the control group in conventional prone position with single hole sheath(atmospheric sheath).Operation time,stone removal rate,bleeding volume and complications of each group were recorded.The clinical data of the two groups were retrospectively analyzed and compared.Results Stone removal rate was higher in observation group(P<0.05),while operation time,intraoperative bleeding volume,incidence of serious complications,incidence of fever,PCT value and CRP value of one day after operation in the observation group were significantly less than those in the control group(P<0.05).Conclusion MPCNL with negative pressure sheath in oblique supine pospine has fewer complications and higher stone removal rate,and oblique supine position does not need to change position for transurethral retrograde ureteral intubation.

关 键 词：肾结石 经皮肾镜 斜仰截石位 负压吸引鞘 

分 类 号：R699.2[医药卫生—泌尿科学]