加压悬挂滴注法在输尿管软镜碎石术中的应用价值  

The Application Value of Pressurized Hanging Drip Infusion Method in Ureteroscopic Lithotripsy

作　　者：王盛[1] 周敏[1] 吴博 王兰 许涛 曹建伟 Wang Sheng;Zhou Min;Wu Bo;Wang Lan;Xu Tao;Cao Jianwei(Department of Urology,Changzhou Hospital of Traditional Chinese Medicine,Changzhou 213003,China;Department of Urology,Xinhua Hospital Affiliated to Shanghai Jiao Tong University,Shanghai 200092,China)

机构地区：[1]江苏省常州市中医医院泌尿外科,常州213003 [2]上海交通大学附属新华医院泌尿外科,上海200092

出　　处：《微创泌尿外科杂志》2024年第6期394-399,共6页Journal of Minimally Invasive Urology

摘　　要：目的:探讨加压悬挂滴注的灌注方式在输尿管软镜碎石术中的应用价值。方法:选取2022年7月至2023年8月在江苏省常州市中医医院泌尿外科诊治的45例通过输尿管软镜碎石术治疗的肾结石患者,按照灌注方式的不同分成3组,其中A组加压悬挂滴注法作为研究组(n=15),B组灌注泵法(n=15)和C组注射器手推注水法(n=15)作为对照组。3组患者术中碎石过程均通过压力导丝实时监测肾盂内压,观察3组患者的手术时间、住院时间、术中肾盂内压力变化以及术后发热情况,并对结果进行对比分析。结果:3组患者的手术时间、住院时间以及术后发热情况比较差异均无统计学意义(均P>0.05),A组术中肾盂内压最大值低于B组和C组,差异有统计学意义(P<0.001);A组的术中肾盂内压平均值低于B组和C组,差异有统计学意义(P=0.006)。结论:输尿管软镜碎石手术中采用加压悬挂滴注的灌注方法技术可行,在维持术中低肾盂压方面有一定优势,操作安全高效,成本低廉,或许会成为一种较为理想的灌注注水方式,值得临床推广应用。Objective:To investigate the application value of the pressurized hanging drip infusion method in ure⁃teroscopic lithotripsy.Methods:A total of 45 patients with renal stones treated by ureteroscopic lithotripsy at the De⁃partment of Urology,Traditional Chinese Medicine Hospital of Changzhou,Jiangsu Province,from July 2022 to Au⁃gust 2023,were selected.The patients were divided into three groups according to the infusion method:Group A(n=15),the study group using the pressurized hanging drip infusion method;Group B(n=15),using the infusion pump method;and Group C(n=15),using the syringe push infusion method as the control group.During the lithotripsy procedure,the intrapelvic pressure was monitored in real time using a pressure guidewire in all three groups.The sur⁃gical time,hospital stay,intraoperative intrapelvic pressure changes,and postoperative fever were observed and com⁃pared among the three groups.Results:There were no statistically significant differences in surgical time,hospital stay,and postoperative fever among the three groups(P>0.05 of all).However,the maximum intrapelvic pressure during surgery in Group A was significantly lower than that in Groups B and C(P<0.001).The mean intrapelvic pressure in Group A was also significantly lower than that in Groups B and C(P=0.006).Conclusion:The pressur⁃ized hanging drip infusion method is feasible in ureteroscopic lithotripsy.It offers certain advantages in maintaining low intrapelvic pressure during the procedure,with high safety,efficiency,and low cost.This method may become an ideal infusion technique and is worthy of clinical promotion.

关 键 词：加压悬挂滴注法 输尿管软镜碎石术 测压导丝 肾盂内压 

分 类 号：R699.1[医药卫生—泌尿科学] R699.4[医药卫生—外科学]