艾克帕斯智能清石系统在经皮肾镜碎石术中的应用研究  

Application of the Ikpas intelligent stone removal system to assist percutaneous nephrolithotomy

作　　者：宋军锋 杨阳[2] 李亚郎 方晓东 党晓青 李烜培 李小楼 SONG Jun-feng;YANG Yang;LI Ya-lang;FANG Xiao-dong;DANG Xiao-qing;LI Xuan-pei;LI Xiao-lou

机构地区：[1]禹州市人民医院泌尿外科,河南禹州461670 [2]郑州大学第一附属医院泌尿外科,河南郑州450000

出　　处：《中国疗养医学》2024年第11期104-108,共5页Chinese Journal of Convalescent Medicine

基　　金：2020年度河南省医学科技攻关计划联合共建立项项目(LHGJ20200990)。

摘　　要：目的分析艾克帕斯智能清石系统(ICPAS)在经皮肾镜碎石术(PCNL)中的应用价值。方法收集禹州市人民医院2020年11月至2023年12月87例输尿管上段结石、肾结石患者临床资料,依照手术方式不同分为两组,对照组(43例)接受PCNL治疗,研究组(44例)接受ICPAS辅助PCNL治疗。比较两组围术期情况(手术时间、结石清除率、出血量、住院时间)、不同时间点(术中6 min、12 min、24 min、36 min)肾盂压力(RPP)、术前及术后1 d肾功能[血尿素氮(BUN)、半胱氨酸蛋白酶抑制剂C(Cys C)、肌酐(Cr)]、应激反应[血清促肾上腺皮质激素(ACTH)、C反应蛋白(CRP)、肾上腺素(AD)、白细胞介素-10(IL-10)、去甲肾上腺素(NE)]、并发症。结果与对照组比较,研究组手术时间、住院时间较短,出血量较少(P<0.05),组间结石清除率差异无统计学意义(P>0.05);不同组间、时间、交互作用下RPP比较差异具有统计学意义,且研究组术中6 min、12 min、24 min、36 min RPP均低于对照组(P<0.05);术后1 d,两组BUN、Cys C、Cr水平均升高,但研究组低于对照组(P<0.05);术后1 d,两组ACTH、CRP、AD、IL-10、NE水平均升高,但研究组低于对照组(P<0.05);研究组并发症发生率6.82%较对照组25.58%低(P<0.05)。结论ICPAS辅助PCNL治疗输尿管上段结石、肾结石患者,能调控肾盂内压力,缩短手术时间,减少出血、并发症,改善肾功能,减轻应激反应,促进恢复。Objective To analyze the application value of the Ikpas intelligent stone removal system(ICPAS)in assisting percutaneous nephrolithotomy(PCNL).Methods The clinical data of 87 patients with upper ureteral and renal calculi treated in Yuzhou City People's Hospital from November 2020 to December 2023 were collected.Patients were divided into the control group(43 cases)receiving PCNL,and the study group(44 cases)receiving the ICPAS-assisted PCNL.The perioperative conditions(operation time,stone clearance rate,blood loss,hospitalization time)and renal pelvis pressure(RPP)at different time points(6 min,12 min,24 min,36 min)were compared between the two groups.Renal function(blood urea nitrogen[BUN],cystatin C[Cys C],creatinine[Cr])and stress response(serum adrenocorticotropic hormone[ACTH],C-reactive protein[CRP],adrenaline[AD],interleukin-10[IL-10],norepinephrine[NE])before and one day after surgery were compared.Complications of the two groups were compared.Results Compared with the control group,the study group had significantly shorter operation time and hospitalization time,and less bleeding volume(P<0.05).No significant difference in stone clearance rate was found between the groups(P>0.05).The differences in RPP between different groups,time points,and interactions were statistically significant,and the RPP in the study group at 6 min,12 min,24 min,and 36 min during the operation was significantly lower than that in the control group(P<0.05).At one day after surgery,the levels of BUN,Cys C,and Cr significantly increased in both groups,but they were significantly lower in the study group than the control group(P<0.05).At one day after surgery,the levels of ACTH,CRP,AD,IL-10,and NE significantly increased in both groups,which were significantly lower in the study group than the control group(P<0.05).The complication rate was significantly lower in the study group than the control group(6.82%VS 25.58%,P<0.05).Conclusion ICPAS-assisted PCNL can regulate the pressure in the renal pelvis,shorten the operation time,red

关 键 词：艾克帕斯智能清石系统 经皮肾镜碎石术 肾功能 尿脓毒血症 应激反应 

分 类 号：R69[医药卫生—泌尿科学]