经皮肾镜取石术中镜鞘大小对患者肾盂内压和血清炎症因子的影响  

Effect of sheath size on renal pelvic pressure and seruminflammatory factors in patients undergoingpercutaneous nephrolithotomy

作　　者：曾芳 洪慧勤 孙颖芳 刘利敏 王瑛 刘华之[2] ZENG Fang;HONG Huiqin;SUN Yingfang;LIU Limin;WANG Ying;LIU Huazhi(Department of Hospital Infection-Control,Longnan First People's Hospital,Ganzhou,Jiangxi,341700,China;Department of Hospital Infection-Control,First Affiliated Hospital of Gannan Medical University,Ganzhou,Jiangxi,341000,China;Department of Nursing,Gannan Normal University Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]龙南市第一人民医院院感科,江西赣州341700 [2]赣南医学院第一附属医院院感科,江西赣州341000 [3]赣南师范大学医院护理部,江西赣州341000

出　　处：《当代医学》2024年第4期117-120,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划课题(GZ2020ZSF543)。

摘　　要：目的观察经皮肾镜取石术(PCNL)中镜鞘大小对患者肾盂内压和血清炎症因子的影响。方法回顾性分析2019年7月至2021年8月70例在龙南市第一人民医院行PCNL患者的临床资料,按照手术顺序单双号分为小镜鞘组(F18通道,镜鞘比为0.47)和大镜鞘组(F16通道,镜鞘比为0.53),各35例。比较两组临床指标、肾盂内压、血清炎症因子及并发症发生情况。结果两组一次性穿刺成功率、取石成功率、术后发热率、术后输血率比较差异无统计学意义;小镜鞘组手术时间短于大镜鞘组,术中出血量少于大镜鞘组,差异有统计学意义(P<0.05)。两组肾盂内压>40cmH_(2)O(1cmH_(2)O=0.098kPa)比例比较差异无统计学意义;小镜鞘组术中肾盂内压低于大镜鞘组,差异有统计学意义(P<0.05)。术后3d,两组白细胞计数、嗜中性粒细胞计数、C反应蛋白水平均高于术前,且小镜鞘组低于大镜鞘组,差异有统计学意义(P<0.05)。两组均未见严重并发症发生。结论相对于大镜鞘PCNL,小镜鞘疗效更好,可降低患者肾盂内压,减轻炎症反应,安全可靠。Objective To observe the effect of sheath size on renal pelvic pressure and serum inflammatory factors in patients undergoing percu-taneous nephrolithotomy(PCNL).Methods The clinical data of 70 patients with PCNL who were treated in Longnan First People's Hospital from July 2019 to August 2021 were analyzed retrospectively,they were divided into the small mirror sheath group(F18 channel,mirror sheath ratio 0.47)and the large mirror sheath group(F16 channel,mirror sheath ratio 0.53)according to the operation sequence single and double numbers,with 35 cas-es in each group.The changes of clinical indexes,renal pelvic pressure,serum inflammatory factors and the incidence of complications were com-pared between the two groups.Results There were no significant differences in the success rate of one-time puncture,stone removal,postoperative fever and postoperative blood transfusion between the two group;the operation time of small mirror sheath group was shorter than that in the large mirror sheath group,and the amount of intraoperative bleeding was less than that in the large mirror sheath group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of>40 cmH_(2)O(1 cmH_(2)O=0.098 kPa)between the two groups,the mean intraoperative renal pelvic pressure in the small mirror sheath group was lower than that in the large mirror sheath group,the differences were statisti-cally significant(P<0.05).At 3 d after operation,the white blood cell count,neutrophil count and C-reactive protein level in the two groups were higher than those before operation,but the small mirror sheath group was lower than the large mirror sheath group,the differences were statistically significant(P<0.05).There was no serious complications in both groups.Conclusion Compared with large mirror sheath of PCNL,small mirror sheath is more effective,which can reduce the pressure in the renal pelvis and reduce the inflammatory reaction,and it is safe and reliable.

关 键 词：经皮肾镜取石术 镜鞘大小 肾盂内压 炎症因子 

分 类 号：R699.2[医药卫生—泌尿科学]