局麻下免逆行插管应用Y型负压吸引鞘行经皮肾镜术疗效分析  

Analysis of the effect of Y-shaped negative pressure suction sheath on percutaneous nephrolithotomy without retrograde intubation under local anesthesia

作　　者：韦高猛[1] 李镇杰 黄华武[1] 卢保德 林志弟[1] 梁正方 韦柳兴 黄勇平[1] Wei Gaomeng;Li Zhenjie;Huang Huawu;Lu Baode;Lin Zhidi;Liang Zhengfang;Wei Liuxing;Huang Yongping(Department of Urology,Ailiated Hospital of Youjiang Medical Collegefor Nationalities,Guangxi,Baise 533000,China)

机构地区：[1]右江民族医学院附属医院泌尿外科,广西百色533000

出　　处：《中华腔镜泌尿外科杂志（电子版）》2022年第4期343-346,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：右江民族医学院附属医院2020年度高层次人才科研项目(Y202011706);右江民族医学院附属医院2019年度第一批高层次人才科研项目(R20196330)。

摘　　要：目的:探讨局部麻醉免逆行插管下运用Y型负压吸引鞘行经皮肾镜碎石取石术(PCNL)的效果。方法:通过倾向性评分匹配肾门或第三腰椎横突以上输尿管单颗或简单多颗结石120例,分为观察组60例和对照组60例。观察组采用局麻下免逆行插管并Y型负压吸引鞘行PCNL治疗,对照组采用椎管内麻醉下普通常压鞘下行PCNL治疗。比较两种不同麻醉及治疗方式下手术出血量、麻醉及手术时间、清石率、疼痛分级、术后进食时间、术后住院时间、治疗费用及并发症等。结果:观察组麻醉及手术时间、术后进食时间、术后住院时间及治疗费用等明显少于对照组(P<0.05);两组间手术出血量、疼痛分级、清石率及并发症的比较,差异无统计学意义(P>0.05)。结论:对于肾及输尿管上段单颗或简单多颗结石,采用局麻免逆行插管Y型负压吸引鞘行PCNL优于椎管内麻下普通鞘行PCNL,值得在临床推广应用。Objective To observe the effect of percutaneous nephrolithotomy(PCNL)with Y-shaped suction sheath under local anesthesia without retrograde intubation.Methods120 cases with single or simple multiple ureteral calculi from renal hilus or above the third lumbar transverse process were included,matched and divided into observation group(60 cases)and control group(60 cases).The observation group was treated with PCNL without retrograde intubation and Y-shaped negative pressure suction sheath under local anesthesia while control group experienced PCNL under general normal pressure sheath under spinal anesthesia.Then the diferences between the two anesthesia and treatment modes were compared,including operative blood los duration of anesthesia and surgery,stone free rate,pain grading postoperative feeding time and hospital stay,treatment costs and complication.ResultsThe anesthesia and operation time,postoperative feeding time and hospital stay and treatment cost of the observation group were significantly lessthan those of the control group(P<0.05),while there was no signifcant diference in the operative blood loss,pain grading,stone freerate and complications between the two groups(P>0.05).ConclusionFor patients with single or simple multiplestones in kidney and upper segment ofureter,PCNL with Y-shaped negative pressure suction sheath under local anesthesia without retrograde is better than PCNL under general normal pressure sheath under spinal anesthesia,which worth clinical application.

关 键 词：局麻 肾结石 经皮肾镜 负压吸引 

分 类 号：R614[医药卫生—麻醉学]