超声引导下经皮肾镜取石术中肾盂内压变化与术后发热的关系

Correlation of renal pelvic pressure in percutaneous nephrolithotomy guided by B-mode ultrasonic diagnostic equipment and the incidence in postoperative fever

目的:探讨超声引导经皮肾镜取石术术中肾盂内压力的变化及与取石术后发热的关系。方法:回顾性分析96例接受经皮肾镜取石术治疗的肾结石患者临床资料,通过压力感受器实时监测术中肾盂内压力及对术后发热的影响。结果:筛选纳入的96例患者术中肾盂内压力≥30mmHg(1mmHg=0.133kPa)平均累计时间为83.17s,平均肾盂内压力为14.79mmHg。术后有26(27.1%)例患者出现发热,与感染性结石、术中平均肾盂内压力≥20mmHg、肾盂内压力≥30mmHg持续时间相关(P<0.05)。而术后发热与患者性别、年龄、尿路感染(UTI)、术后血常规白细胞≥10×109/L、术中肾盂内压力≥35mmHg无明显关系(P>0.05)。结论:经皮肾镜取石术术中平均肾盂内压力、肾盂内压力≥30mmHg持续时间与术后发热的发生率呈正相关,而肾盂内压力短暂性升高(≥35mmHg)与术后发热无明显关系。

Objective：To investigate the correlation of renal pelvic pressure （RPP） in percutaneous nephrolithotomy （PCN） guided by B-ultrasound and the incidence in postoperative fever. Method：The clinical data about the patients with renal calculus treated by PCN were retrospective analyzed. The effect of the RPP real-time measured by baroceptor in PCN and postoperative fever were evaluated statistically. Result： The average persistence time of RPP≥30 mmHg was 83.17 s and the mean RPP was 14.79 mmHg in the selected 96 patients. 26 cases （27. 1%） developed a postoperative fever. Postoperative fever correlated to infection calculi, the average RPP^20 mmHg, and RPP≥30 mmHg longer than 45 s （ P 〈0.05）, while sex, age, urinary tract infection （UTI）, white blood cell^10 X 109/L in postoperative blood routine test, a temporary appearance of RPP≥35 mmHg on occasion did not contribute to postoperative fever （ P 〉0.05） with logistic analysis. Conclusion：The mean RPP and the average persistence time of RPP≥30 mmHg were positive correlation with the incidence in postoperative fever, while a temporary appearance of RPP≥35 mmHg did not contribute to postoperative fever.