mPCNL术中灌注压力对肾盂内压力的影响  

Effect of Perfusion Pressure on Intrarenal Pressure during mPCNL

作　　者：石柱 邱士禄 曹鸿飞 SHI Zhu;QIU Shi-lu;CAO Hong-fei(Department of Urology,Affiliated Hospital of Shanxi Datong University,Datong Shanxi,037005)

机构地区：[1]山西大同大学附属医院泌尿外科,山西大同037005

出　　处：《山西大同大学学报（自然科学版）》2022年第1期80-83,88,共5页Journal of Shanxi Datong University(Natural Science Edition)

摘　　要：目的探讨灌注压力设定在微创经皮肾镜碎石术中对于肾盂内压力的影响。方法将接受mPCNL治疗的63例患者随机分为4组,各组术中分别设定灌注压力13~15、16~18、19~21、23~25 kPa,对术中各组肾盂初始压力,肾盂最大压力,肾盂最大压力超过30 mmHg时间,碎石时间以及术后感染情况进行记录分析。结果4组患者初始肾盂内压力组间对照无明显差异;术中肾盂最大压力组间比较均有差异;在灌注压力超过19 kPa时肾盂最大压力均超过30 mmHg;灌注压力低于15 kPa时碎石时间较其他组延长。结论当灌注压力设定在16~18 kPa之间,mPCNL术中肾盂压力可全程控制在30 mmHg以内。高于该设定压力,肾盂内最大压力会超过30 mmHg的安全阈。当灌注压力低于15 kPa,会有出血冲开不及时、视野受干扰和结石冲出无力等现象,延长手术时间。Objective To explore the effect of perfusion pressure on intrarenal pressure in minimally invasive percutaneous nephrolithotripsy.Method 63 patients underwent mPCNL were randomized into four groups,irrigation pressures 13~15 kPa,16~18 kPa,19~21 kPa,23~25 kPa were set respectively in each group.Initial intrapelvic pressure,maximum value of intrapelvic pressure,accumulative time of intrapelvic pressure>30 mmHg,calculus removing time and infection after operation were recorded and xicompared.Results There is no significant difference in initial intrapelvic pressure in four groups;Significance difference was showed in maximum value of intrapelvic pressure during the operation between each two groups;The maximum intrapelvic pressure exceeded 30 mmHg when irrigation pressure was set over 19 kPa;Calculus removing time were prolonged when irrigation pressure was set lower than 15 kPa vs the other groups.Conclusion Intrapelvic pressure can be controlled under 30 mmHg all through mPCNL operation when 16~18 kPa irrigation pressure were defined.Maximum value of intrapelvic pressure will go beyond more than 30mmHg when irrigation pressure is set exceed this safety threshold.Calculus removing time will be extended when irrigation pressure is set under 15 kPa with a performance of visual field distured and calculus removed unsmoothly.

关 键 词：经皮肾镜碎石术 微创经皮肾镜碎石术 灌注压力 肾盂内压力 

分 类 号：R692.4[医药卫生—泌尿科学]