经皮肾镜取石术中不同灌注压力对肾结石患者的影响  

Effect of Different Perfusion Pressure in Percutaneous Nephrolithotomy on Patients with Renal Calculi

作　　者：刘杰 袁观远 LIU Jie;YUAN Guanyuan(不详;Yangxin County People’s Hospital,Yangxin 435200,China)

机构地区：[1]阳新县人民医院,湖北阳新435200

出　　处：《中外医学研究》2022年第23期34-37,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：湖北省卫生健康委员会联合基金项目(WJ2019H452)。

摘　　要：目的:探讨经皮肾镜取石术中不同灌注压力对肾结石患者的影响。方法:选取2020年3月-2021年3月阳新县人民医院收治的82例肾结石患者作为研究对象。按照随机数字表法将其分为对照组和观察组,各41例。经皮肾镜取石术治疗中,对照组持续灌注压力>140 mmHg,观察组持续灌注压力≤140 mmHg。比较两组围手术期情况,术前和术后24 h生命体征及休克指数、相关指标。结果:观察组冲洗液用量少于对照组,术后发热、残石率均低于对照组(P<0.05)。术后24 h,观察组体温、收缩压、休克指数均低于对照组(P<0.05),两组脉率比较差异均无统计学意义(P>0.05)。与术前比较,术后24 h两组白细胞(WBC)、中性粒细胞(NEUT)及血清血肌酐(Scr)均升高,观察组NEUT、Scr均低于对照组(P<0.05)。结论:肾结石患者经皮肾镜取石术中,低灌注压力具有术野清晰,冲洗液用量少等特点,术后发热和残石的发生情况相对较少,且可有效维持患者生命体征稳定,改善患者肾功能,降低细菌感染及术后感染的风险。Objective:To investigate the effect of different perfusion pressure in percutaneous nephrolithotomy on patients with renal calculi.Method:A total of 82 patients with renal calculi treated in Yangxin County People’s Hospital from March 2020 to March 2021 were selected as the research objects.According to the random number table method,they were divided into control group and observation group,with 41 cases in each group.In the treatment of percutaneous nephrolithotomy,the continuous perfusion pressure in the control group was>140 mmHg,and continuous perfusion pressure in the observation group was≤140 mmHg.The perioperative conditions,vital signs,shock index and related indicators before surgery and 24 h after surgery were compared between the two groups.Result:The dosage of irrigation fluid in the observation group was less than that in the control group,and the postoperative fever and residual stone rates were lower than those in the control group(P<0.05).24 h after surgery,the body temperature,systolic blood pressure and shock index of the observation group were lower than those of the control group(P<0.05),and there were no significant differences in pulse rate between the two groups(P>0.05).Compared with before surgery,white blood cells(WBC),neutrophil(NEUT)and serum creatinine(Scr)in the two groups increased 24 h after surgery,while NEUT and Scr in the observation group were lower than those in the control group(P<0.05).Conclusion:During percutaneous nephrolithotomy for patients with renal calculi,low perfusion pressure has the characteristics of clear operation field and less amount of washing fluid.The occurrence of postoperative fever and residual stones is relatively less,and it can effectively maintain the stability of patients’vital signs,improve patients’renal function,and reduce the risk of bacterial infection and postoperative infection.

关 键 词：肾结石 经皮肾镜取石术 灌注压力 白细胞 

分 类 号：R699.2[医药卫生—泌尿科学]