微创经皮肾镜碎石术中肾盂压力变化与术后早期并发症的关系研究

Relationship between the early incidence of postoperative complications and renal pelvic pressure during minimally invasive percutaneous nephrolithotomy

目的：探讨微创经皮肾镜碎石术（ minimally invasive percutaneous nephrolithotomy,MPCNL）中肾盂压力变化及高压累积时间与术后早期并发症发生率的关系。方法对133例肾结石患者采用MPCNL治疗,监测术中肾盂压力及高压累积时间,将患者分为高压及低压组,分析2组患者术后发热、肾周积液及肾功能损害发生情况。结果高压组术后1~4d平均体温高于低压组,差异有统计学意义（P〈0.05）。所有患者术后第1天尿蛋白明显高于术前,此后尿蛋白逐渐下降,高压组与低压组同一天所测尿蛋相比,差异有统计学意义（P〈0.05）。肾周积液发生率高压手术组显著高于低压手术组,差异有统计学意义（P〈0.05）。结论微创经皮肾镜碎石术后早期并发症的发生率与术中高肾盂压相关。

Objective To evaluate the relationship between the early incidence of postoperative complications and renal pelvic pressure during minimally invasive percutaneous nephrolithotomy. Methods 133 renal calculi patients were monitored during MPCNL. Then the patients＆nbsp;were separated into two groups according to the renal pelvic pressure,and the postoperative fever,the perirenal fluid and impairment of renal function were analyzed. Results The average body temperature was higher in high pelvic pressure group than that in low pelvic pressure group from the first day to the fourth day after operation（P〈0. 05）. The urinary protein of all patients raised obviously after the op-eration while it decreased gradually afterward. The urinary protein of the high pelvic pressure group was much higher than that of the low pel-vic pressure group in same day with a significant difference （P〈0. 05）. The incidence of perirenal fluid was much higher in high pelvic pres-sure group than that in low pelvic pressure group （P〈0. 05）. Conclusion The incidence of early postoperative complications was related to renal pelvic pressure during MPCNL.