负压吸引鞘在微创经皮肾镜碎石取石术中的应用  

The application of negative pressure suction sheath in minimally invasive percutaneous nephrolithotomy

作　　者：范翰共 刘聪 洪佳辉 林悦悦 林斯琪 Fan Hangong;Liu Cong;Hong Jiahui;Lin Yueyue;Lin Siqi(Department of Urology,Shanwei Yihui Foundation Hospital,Guangdong 516600,China)

机构地区：[1]汕尾逸挥基金医院泌尿外科,广东516600

出　　处：《中华腔镜泌尿外科杂志（电子版）》2023年第2期140-143,共4页Chinese Journal of Endourology(Electronic Edition)

基　　金：汕尾市科技计划项目(2019C011)。

摘　　要：目的比较负压吸引鞘与普通鞘行微创经皮肾碎石取石术(MPCNL)治疗2~5 cm肾结石的疗效,以验证其安全性及有效性。方法自2019年,我科将50例直径2~5 cm肾结石患者随机分为两组,分别采用负压吸引鞘和普通鞘进行18 F通道下的MPCNL。记录术前资料、手术时间、碎石时间、取石体积以及围手术期并发症等,进行统计学分析。结果负压吸引鞘与普通鞘两组患者术前资料差异无统计学意义,MPCNL术中分别取出结石(8±3)和(8±4)mm^(3),差异无统计学意义(P=0.781),但负压吸引鞘组碎石取石时间[(37±16)vs(50±20)min,P=0.016]较普通鞘组显著缩短,单位时间内负压吸引鞘组的碎石取石效率[(13.5±1.0)vs(9.7±1.1)mm^(3)/h,P<0.001]显著高于普通鞘组。负压吸引鞘组的总手术时间[(54±16)vs(67±20)min,P=0.014]较普通鞘组显著缩短。负压吸引鞘组较普通鞘组术后血红蛋白下降量[(14±6)vs(19±8)g/L,P=0.013]少;负压吸引鞘组术后发热率(4%vs 24%,P=0.042)更低。结论负压吸引鞘在MPCNL中能够提高碎石取石的效率,缩短手术时间,并减少术中出血及术后发热风险,是一项安全有效的技术。Objective To compare the safety and efficacy of negative pressure suction sheath and peel-away sheath in minimally invasive percutaneous nephrolithotomy(MPCNL)for 2-5 cm renal calculi.Methods From 2019,50 patients with 2-5 cm renal calculi were enrolled into two groups.18 F percutaneous tract was established,suction sheath and peel-away sheath were used in different groups.Preoperative data,operation time,lithotripsy time,stone removal volume and perioperative complications were recorded and analyzed statistically.Results There was no significant difference in preoperative data between the two groups.There was no significant difference in stone removal volume[(8±3)vs(8±4)mm^(3),P=0.781]during MPCNL,but the time consumed[(37±16)vs(50±20)min,P=0.016]for lithotripsy in the negative pressure suction sheath group was significantly shorter than peel-away sheath group,therefore,the lithotripsy efficiency[(13.5±1.0)vs(9.7±1.14)mm^(3)/h,P<0.001]of the negative pressure suction sheath group was significantly higher than peel-away sheath group.The total operation time[(54±16)vs(67±20)min,P=0.014]in the negative pressure suction sheath group was significantly shorter than that of ordinary sheath group.The decrease of hemoglobin[(14±6)vs(19±8)g/L,P=0.013]in the negative pressure suction sheath group was less than peel-away sheath group.The postoperative fever rate(4%vs 24%,P=0.042)was lower in the negative pressure suction sheath group.Conclusions Negative pressure suction sheath in MPCNL can improve the lithotripsy efficiency,shorten the operation time,effectively reduce the blood loss and postoperative fever,which is a safe and effective technique.

关 键 词：负压吸引鞘 肾结石 经皮肾镜 并发症 

分 类 号：R699.2[医药卫生—泌尿科学]