负压鞘吸引微通道经皮肾镜钬激光碎石术治疗复杂性肾结石的临床效果  

Clinical Efficacy of Negative Pressure Sheath Suction Minimally Invasive Percutaneous Nephrolithotripsy with Holmium Laser for the Treatment of Complex Renal Caculi

作　　者：蔡卫华 CAI Weihua(Department of Urology,Xiapu County Hospital,Xiapu,Fujian,355100,China)

机构地区：[1]霞浦县医院泌尿外科,福建霞浦355100

出　　处：《中外医疗》2025年第5期44-48,共5页China & Foreign Medical Treatment

摘　　要：目的探究负压鞘吸引微通道经皮肾镜碎石术(minimally invasive percutaneous nephrolithotomy,MPCNL)用于复杂性肾结石的疗效。方法方便选取2020年9月—2023年9月霞浦县医院收治的86例复杂性肾结石患者为研究对象,按照不同手术方法分为各43例的两组,分别为对照组、观察组。对照组行MPCNL,观察组行负压鞘吸引MPCNL。对比两组围手术期指标、一次性结石清除率、肾功能、肾血流动力学、应激指标、炎症因子、尿路感染发生情况。结果手术时间、首次下床时间观察组均短于对照组,术中出血量观察组更少,差异均有统计学意义(P均<0.05)。相较于对照组的79.07%(34/43),观察组一次性结石清除率95.35%(41/43)更高,差异有统计学意义(χ^(2)=5.108,P=0.024)。相较于术前,两组术后胱抑素C、血肌酐水平均更高,观察组比对照组低;与术前相比,肾动脉阻力指数水平两组术后更高,肾动脉收缩期峰值流速、肾动脉舒张末期流速水平均更低;观察组肾动脉阻力指数水平比对照组低,肾动脉收缩期峰值流速、肾动脉舒张末期流速水平均比对照组更高,差异均有统计学意义(P均<0.05)。与术前相比,应激水平指标两组术后更高,应激水平及炎症指标观察组均比对照组更低,差异均有统计学意义(P均<0.05)。观察组感染发生率低于对照组,但差异无统计学意义(P>0.05)。结论复杂性肾结石采用负压鞘吸引MPCNL治疗,手术时间短、结石清除率高,并可减轻应激反应,对肾功能影响较小,有利于预后恢复。Objective To investigate the efficacy of minimally invasive percutaneous nephrolithotomy(MPCNL)with negative pressure sheath suction in the treatment of complex renal calculi.Methods A total of 86 patients with complex renal calculi admitted to Xiapu County Hospital from September 2020 to September 2023 were conveniently selected as the research objects.According to different surgical methods,they were divided into two groups of 43 cases each,namely the control group and the observation group.The control group underwent MPCNL,and the observation group underwent negative pressure sheath suction MPCNL.The perioperative indicators,one-time stone clearance rate,renal function,renal hemodynamics,stress indicators,inflammatory factors and occurrence of urinary tract infection were compared between the two groups.Results The operation time and the first time to get out of bed in the observation group were shorter than those in the control group,and the intraoperative blood loss was less in the observation group,the differences were statistically significant(P<0.05).Compared with 79.07%(34/43)in the control group,the one-time stone clearance rate in the observation group[95.35%(41/43)]was higher,and the difference was statistically significant(χ^(2)=5.108,P=0.024).Compared with before operation,the levels of cystatin C and serum creatinine were higher in the two groups after operation,and the observation group was lower than the control group,compared with before operation,the level of renal artery resistance index in the two groups was higher after operation,and the levels of renal artery peak systolic velocity and renal artery end diastolic velocity were lower,the level of renal artery resistance index in the observation group was lower than that in the control group,and the levels of renal artery peak systolic velocity and renal artery end diastolic velocity in the observation group were higher than those in the control group,the differences were statistically significant(all P<0.05).Compared with before operation,th

关 键 词：负压鞘吸引 微通道经皮肾镜碎石术 复杂性肾结石 肾功能 

分 类 号：R692.4[医药卫生—泌尿科学]