微通道经皮肾镜术后气囊导尿管牵拉的止血作用

Foley catheter traction for hemorrhage after postmicrochannel percutaneous nephrolithotomy

目的:观察临床应用气囊导尿管牵拉法对微通道经皮肾镜碎石术(microchannel percutaneousnephrolithotomy,mPCNL)术后出血的疗效。方法:自2010年11月至2011年4月,前瞻性收集明确诊断为上尿路结石且应用mPCNL治疗的88例患者的临床资料,随机将病例资料分为气囊导尿管不牵拉止血组(对照组,n=45)与气囊导尿管牵拉止血组(实验组,n=43)。通过氰化高铁血红蛋白法测量出血量。使用Wilcoxon秩和检验分析两组出血量的关系。结果:术后对照组平均出血量为13.830 g,出血时间为4 d;实验组平均出血量为7.959 g,出血时间为3 d。经Wilcoxon秩和检验,两组出血量的比较具有明显统计学意义(P<0.001)。结论:对于mPCNL术后出血,施行气囊导尿管牵拉压迫止血能够明显减少术后出血量,实验证实有效,临床观察可行。

Objective： To evaluate the safety and effect of foley catheter traction for hemorrhage after post- microchannel percutaneous nephrolithotomy （mPCNL）. Methods： Eighty-eight patients with upper urinary calculi were collected prospectively at the Department of Urology of Xiangya Hospital of Central South University from November 2010 to June 2011. The patients underwent mPCNL, and were divided into 2 groups randomly： 45 patients with 16F foley catheter but without traction served as the control group, and the other 43 patients with 16F foley catheter traction served as the experiment group. Blood loss was estimated by the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN. The blood loss and bleeding time were compared in the 2 groups, and analyzed by Wilcoxon rank sum test. Results： There was statistical difference in the average blood loss between the control group （13.830 g） and the experiment group （7.959 g, P〈0.001）. The mean bleeding time was 4 and 3 days in the control group and the experiment group respectively. Conclusion： Foley catheter traction for mPCNL can reduce the blood loss, suggesting that Foley catheter traction is safe, effective and feasible.