联合工作鞘在微创经皮肾镜取石术中的应用价值

Value of combining different sheath in minimally percutaneous nephrolithotomy

目的探讨微创经皮肾镜取石术(MPCNL)中联合应用16F和20F工作鞘的效果和安全性。方法对60例行MPCNL的肾结石患者,术中随机分16F和20F工作鞘单用和16F+20F联合应用3组各20例,比较3组手术时间、术中出血量、术中灌注液用量、术中平均肾盂内压及术后结石一期清除率的差异。结果所有病例均能成功建立相应大小的工作通道。16F、20F和16F+20F组平均手术时间分别为(102±20)、(118±19)和(82±22)min,术中平均灌注液用量分别为(26.7±14.8)、(31.5±19.1)和(19.8±11.7)L,术中平均肾盂内压分别为(28.6±13.9)、(13.9±15.2)和(14.3±12.1)mmHg,差异均有统计学意义(P<0.05);术中平均出血量分别为(119±40)、(118±42)和(120±36)mL,术后一期结石清除率分别为70%(14/20)、60%(12/20)和70%(14/20),差异均无统计学意义(P>0.05)。结论MPCNL中联合应用16F和20F工作鞘安全、有效,可明显减少手术时间及灌注液用量,降低术中肾盂内压,值得临床推广应用。

[Objective] To investigate the efficiency and safety of combining different sheath in minimally percutaneous nephrolithotomy (MPCNL) for the treatment of renal calculi. [Methods] A total of 60 patients who underwent MPCNL for renal calculi were enrolled and divided randomly into three groups according 16 F, 20 F and combining 16 F and 20 F sheath were uesed. Full details of each operation such as the operative time, irrigation fluid volume, renal pelvic pressure, blood loss and phase Ⅰ stone-free rate were ...