持续肾盂内压监测在微创经皮肾镜碎石术中的应用及其临床意义

Application and clinical significance of continuous renal pelvic pressure monitoring in MPCNL surgery

目的介绍持续肾盂内压监测在微创经皮肾镜碎石（MPCNL）术中的应用，并探讨其临床意义。方法将100例行MPCNL手术的肾结石患者随机分成两组：实验组（50例）术中行持续肾盂内压监测，尽量避免肾盂内压力≥30mmHg；对照组（50例）术中无肾盂内压监测。统计术后发热、疼痛指数及血红蛋白的下降值等相关临床指标，探讨其与肾盂内压监测的关系。结果实验组患者术后发热、血红蛋白的下降值及疼痛指数均明显低于对照组（P〈0．05），两组间的结石清除率差异无统计学意义（P〉0．05）。结论MPCNL术中常规监测肾孟内压变化可以减少术后并发症，且不影响结石清除率。

Objective To introduce the application of continuous renal pelvic pressure （RPP） mo- nitoring in minimally invasive percutaneous nephrolithotomy（MPCNL） surgery and investigate its clinical significance. Methods The clinical data of 100 patients with kidney stones were randomly divided into experimental group（ 50 cases）and control group（ 50 cases）. All patients underwent MPCNL. In the experi- mental group, the continuous RPP monitoring were performed intraoperatively to keep the pressure below 30 nunHg; In the control group, RPP was not measured. Clinical indicators were recorded,including postoper- ative fever,pain scores and hemoglobin decline. The relationship between the indicators and intrapelvic pressure monitoring was discussed. Results The incidence of postoperative fever, hemoglobin decline and pain scores in the experimental group were significantly lower than that in the control group （ P 〈 0.05 ）, and there was no significant difference in the stone clearance rate between the two groups. Conclusion The routine monitoring of RPP in MPCNL surgery may reduce the postoperative complications and does not affect stone clearance.