| 杨权,刘健,付慧锋,等.微通道负压鞘经皮肾镜取石术治疗肾结石合并感染的疗效分析[J].安徽医药,2025,29(5):958-962. |
| 微通道负压鞘经皮肾镜取石术治疗肾结石合并感染的疗效分析 |
| Effect analysis of percutaneous nephrolithotomy with microchannel negative pressure sheath for kidney stones complicated with infection |
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| DOI：10.3969/j.issn.1009-6469.2025.05.020 |
| 中文关键词: 肾结石 经皮肾镜取石术 微通道 负压鞘 感染 快速康复 |
| 英文关键词: Kidney calculi Percutaneous nephrolithotomy Microchannel Negative pressure sheath Infection Rapid recovery |
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| 中文摘要: |
| 目的探讨微通道负压鞘应用于肾结石合并感染的疗效分析。方法回顾性分析 2021年 1月至 2023年 6月湖南省人民医院泌尿外科用经皮肾镜取石术( percutaneous-nephrolithotom-y，PCNL)治疗肾结石合并感染的 200例临床资料。根据术中是否使用微通道负压鞘分为微通道负压鞘组(观察组)和传统微通道无负压组(对照组)各 100例。所有手术均采用超声引导下穿刺，观察组建立微通道大小为 18 Fr，连接负压装置，对照组建立微通道大小为 18 Fr，无负压装置。分析两组一般资料、术中临床资料、术后临床资料。结果两组年龄、糖尿病、性别、结石长径、结石成分、 STONE评分、手术部位、术前尿培养阳性、术前术后降钙素比较，差异无统计学意义( P>0.05)；观察组与对照组手术时间［( 55.82±11.15)min比( 88.28±22.02)min］、肾盂中压力 ≥30 mmHg累计时间［( 31.23±12.61)min比( 160.00±34.05)min］、术中出血量［10(5，20)mL比 20(10，50)mL］、术后发热率、术后住院时间、术前术后的白细胞变化量以及 C反应蛋白变化量、术后疼痛评分、术后残石率及全身炎症反应综合征或脓毒血症发生率比较，差异有统计学意义( P<0.05)。结论微通道负压鞘 PCNL应用于肾结石合并感染病人，可以减少术后发热、出血等并发症的发生，甚至可以有效预防脓毒血症或者感染性休克的发生，降低残石率。并且能减少术后疼痛，缩短术后住院时间，帮助术后病人快速康复。 |
| 英文摘要: |
| Objective To investigate the therapeutic effect of microchannel negative pressure sheath on kidney stones complicated with infection.Methods Clinical data of 200 patients with renal calculus complicated with infection treated by percutaneous nephroli-thotom-y (PCNL) in the Department of Urology of Hu'nan People's Hospital from January 2021 to June 2023 were retrospectively ana-lyzed. According to whether the microchannel negative pressure sheath was used during the operation, the patients were divided intothe microchannel negative pressure sheath group (study group, n=100) and the traditional microchannel no negative pressure group (control group, n=100). Ultrasound guided puncture was used in all operations. The study group established a microchannel with a sizeof 18 Fr and a negative pressure device was connected, while the control group established a microchannel with a size of 18 Fr and nonegative pressure device. The general data, intraoperative clinical data and postoperative clinical data of all patients were statisticallyanalyzed.Results There were no significant differences between the study group and the control group in age, diabetes mellitus, sex,stone size, stone component analysis, STONE score, surgical site, preoperative urine culture, and preoperative and postoperative calcito-nin changes (P>0.05).There were statistical significance in operation time [(55.82±11.15) min vs. (88.28±22.02) min], cumulative time of renal pelvis pressure ≥30 mmHg [(31.23±12.61) min vs. (160.00±34.05)min], intraoperative blood loss [10 (5, 20)mL vs. 20 (10, 50) mL], postoperative fever rate, postoperative hospital stay, changes in white blood cells and C-reactive protein before and after surgery,postoperative pain score, postoperative stone residue rate, and incidence of systemic inflammatory response syndrome or sepsis betweenthe two groups(P<0.05).Conclusions The application of micro-channel negative pressure sheath PCNL in patients with kidney stonescombined with infection can reduce the occurrence of postoperative complications such as fever and bleeding, and even effectively pre-vent the occurrence of sepsis or septic shock, and reduce the rate of residual stone. It can reduce postoperative pain, shorten postopera-tive hospital stay, and help postoperative patients recover quickly. |
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