肾盂内压实时监测下负压清石鞘PCNL治疗结石梗阻性肾积脓的效果  

Effect of Negative Pressure Stone Cleaning Sheath PCNL under Real-time Monitoring of Renal Pelvic Pressure in the Treatment of Calculous Obstructive Pyonephrosis

作　　者：吴小伟[1] 曾健文[1] 曾少华[1] 周秋燕 WU Xiaowei;ZENG Jianwen;ZENG Shaohua;ZHOU Qiuyan(The Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan 511500,China;不详)

机构地区：[1]广州医科大学附属第六医院,广东清远511500

出　　处：《中外医学研究》2023年第19期1-4,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：清远市科技计划项目(190831214566647)。

摘　　要：目的:研究肾盂内压(renal pelvic pressure,RPP)实时监测下负压清石鞘经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)治疗结石梗阻性肾积脓的效果。方法:选取2019年11月—2022年3月广州医科大学附属第六医院收治的64例结石梗阻性肾积脓患者作为研究对象。根据随机数表法将其分为观察组和对照组,各32例。观察组给予RPP实时监测下负压清石鞘PCNL治疗,对照组给予常规PCNL分期治疗。比较两组围手术期指标,结石清除率及并发症,术后1 d生理相关指标。结果:观察组手术时间、灌注时间、住院时间短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组住院费用比较,差异无统计学意义(P>0.05)。观察组术后30 d结石清除率高于对照组,术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。两组术后1 d血红蛋白下降值、血清胱抑素C增长值、血清降钙素增长值比较,差异无统计学意义(P>0.05)。结论:RPP实时监测下负压清石鞘PCNL治疗结石梗阻性肾积脓患者能有效提高患者结石清除率,优化患者手术指标、减少并发症。Objective:To study the effect of negative pressure stone cleaning sheath percutaneous nephrolithotomy(PCNL)under real-time monitoring of renal pelvic pressure(RPP)in the treatment of calculous obstructive pyonephrosis.Method:Sixty-four patients with calculous obstructive pyonephrosis who were admitted to the Sixth Affiliated Hospital of Guangzhou Medical University from November 2019 to March 2022 were selected as the study objects.According to random number table method,the patients were divided into observation group and control group,32 cases in each group.The observation group was treated with negative pressure stone cleaning sheath PCNL under real-time monitoring of RPP.The control group was given conventional PCNL staging treatment.Perioperative indexes,stone clearance rate and complications,and physiological related indexes 1 d after operation were compared between the two groups.Result:The operation time,perfusion time and hospital stay in the observation group were shorter than those in the control group,and the intraoperative blood loss volume was less than that in the control group,the differences were statistically significant(P<0.05).The hospitalization cost was not statistically significant between the two groups(P>0.05).The stone clearance rate 30 d after operation in the observation group was higher than that in the control group,and the incidence of postoperative complications was lower than that in the control group,the differences were statistically significant(P<0.05).There were no significant differences in hemoglobin decline value,cystatin C increase value and calcitonin increase value between the two groups 1 d after operation(P>0.05).Conclusion:In the treatment of patients with obstructive renal pyonephrosis treated with negative pressure stone cleaning sheath PCNL under real-time monitoring of RPP,the stone clearance rate of patients can be effectively improved,the surgical indicators of patients can be optimized,and complications can be reduced.

关 键 词：肾盂内压 负压清石鞘 经皮肾镜取石术 结石梗阻性肾积脓 结石 并发症 

分 类 号：R699[医药卫生—泌尿科学]