负压清石鞘在经皮肾取石术中应用

摘要

目的 探讨负压清石鞘在经皮肾镜取石术(PCNL)中临床应用价值.方法 回顾性分析2016年3月至2016年10月间,广州医科大学附属第五医院(32例)及广州中医药大学金沙洲医院(18例)采用负压清石鞘行PCNL的50例患者的临床资料,通过分析清石时间、结石成分、结石清除率来比较术前术后血红蛋白水平、肌酐的变化;统计术后发热、出血、脓毒血症等并发症发生的病例数据.结果 手术均获得成功,结石直径3.5～7.0 cm,平均5.5 cm,清石时间25～45 min,平均32 min.术后住院时间5～9 d,平均住院天数7.2d.总结石清除率为94％(47/50),术后发热3例(6％),术中术后均无明显大出血,无病例行超选择肾动脉栓塞术.结论 在经皮肾镜碎石取石术中使用负压清石鞘,可提高清石效率,降低肾盂内压,减少术后发热,值得临床推广.%Objective To explore the clinical value of negative pressure sheath in minimally invasive percutaneous nephrolithotomy (MPCNL).Methods Clinical data of 50 patients who underwent MPCNL combined with negative pressure sheath during Mar.to Oct.2016 were retrospectively analyzed.The operation time,stone composition,stone clearance rate,preoperative and postoperative hemoglobin levels,creatinine,and complications were observed.Results All operations were successful.The mean diameter of the calculi was 3.5 cm (5.5-7.0 cm).The mean operation time was 32 min (25-45 min).Postoperative hospital stay was 7.2 days (5 9 days).The stone clearance rate was 94％ (47/50).No significant hemorrhage was observed,and no cases underwent superselective renal artery embolization.3 cases had postoperative fever.Conclusion Negative pressure sheath in MPCNL can significantly shorten the operation time and reduce the rate of complications.It is worthy of clinical application.