负压吸引在上尿路结石并脓肾Ⅱ期经皮肾镜取石术中的效果评估  

Evaluation of the effect of negative pressure suction in stage Ⅱ percutaneous nephrolithotomy of upper urinary tract calculi with pyonephrosis

作　　者：张遂兵[1] 潘卫兵[1] 金岩[1] ZHANG Sui-bing;PAN Wei-bing;JIN Yan(Department of Urology Surgery,Shenzhen Pingshan New District People’s Hospital,Shenzhen 518118,China)

机构地区：[1]广东省深圳市坪山新区人民医院泌尿外科

出　　处：《中国实用医药》2019年第33期10-12,共3页China Practical Medicine

基　　金：深圳市坪山区卫生系统科研项目(项目编号：201718)

摘　　要：目的评估负压吸引在上尿路结石并脓肾患者Ⅱ期经皮肾镜取石术(PCNL)中的应用价值。方法72例行Ⅱ期PCNL治疗的上尿路结石合并脓肾患者,随机分为负压组(42例)和常规组(30例)。常规组术中采用常规方法,负压组术中采用负压吸引。比较两组患者手术时间、血红蛋白下降比例、结石清除情况、术后并发症发生情况,手术前后肾功能[尿素氮(BUN)、血清肌酐(SCr)]及炎症因子[C反应蛋白(CRP)、降钙素原(PCT)]水平。结果负压组手术时间(43±13)min短于常规组的(55±13)min,差异有统计学意义(P<0.05);负压组血红蛋白下降比例为(14±3)%,常规组血红蛋白下降比例为(15±1)%;两组血红蛋白下降比例比较差异无统计学意义(P>0.05)。手术后,两组BUN、SCr、CRP、PCT水平均明显高于手术前,但负压组BUN、Cr、CRP、PCT水平均低于常规组,差异均有统计学意义(P<0.05)。负压组结石清除率90.48%高于常规组的70.00%,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论负压吸引应用于上尿路结石并脓肾患者Ⅱ期经皮肾镜取石术中,安全、有效、结石清除率高,肾功能影响小,能有效降低炎症水平。Objective To evaluate the application value of negative pressure suction in stageⅡpercutaneous nephrolithotomy(PCNL)of upper urinary tract calculi with pyonephrosis.Methods A total of 72 cases of upper urinary tract calculi with pyonephrosis treated by stageⅡPCNL were randomly divided into negative pressure group(42 cases)and conventional group(30 cases).The conventional group received conventional therapy,and negative pressure group received negative pressure suction.Comparison was made on operation time,decline proportion of hemoglobin,calculi clearance situation and occurrence of postoperative complications,renal function[blood urea nitrogen(BUN),serum creatinine(SCr)]and levels of inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT)]before and after operation in the two groups.Results The operation time(43±13)min in negative pressure suction group was shorter than(55±13)min in conventional group,and the difference was statistically significant(P<0.05).The decline proportion of hemoglobin was(14±3)%in negative pressure suction group,which was(15±1)%in conventional group,and the difference was not statistically significant(P>0.05).After operation,the levels of BUN,SCr,CRP and PCT in the two groups was obviously higher than those before operation,but the levels of BUN,SCr,CRP and PCT in negative pressure suction group was lower than those in conventional group.Their difference was statistically significant(P<0.05).The calculi clearance rate 90.48%in negative pressure suction group was higher than 70.00%in conventional group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in incidence of complications between the two groups(P>0.05).Conclusion It is safe and effective of negative pressure suction for patients with upper urinary tract calculi and pyonephrosis treated by stageⅡPCNL,and it shows high stone clearance rate,small renal function.It also can reduce the level of inflammation effectively.

关 键 词：负压吸引 上尿路结石 脓肾 Ⅱ期经皮肾镜取石术 

分 类 号：R69[医药卫生—泌尿科学]