负压清石鞘在经皮肾镜取石术中的应用价值

Application value of negative pressure clear stone sheath in percutaneous nephrolithotomy

目的介绍一种经皮肾镜取石术(PCNL)中清石的新方法,探讨负压清石鞘在PCNL中的有效性及安全性。方法将2017年3月至2018年3月咸阳市第一人民医院和西电集团医院PCNL中结石负荷接近的73例患者根据是否应用负压清石鞘分为两组,观察组36例,应用负压清石鞘组,对照组37例,应用常规的Peel-away鞘,两组均建立F18穿刺通道。观察两组的清石时间、术中及术后并发症发生情况。结果观察组有28例患者清石时间<25 min,显著多于对照组的11例(P<0.05)。两组患者的术中并发症发生率无显著差异(P>0.05)。观察组术后残石发生率显著低于对照组(P<0.05)。结论负压清石鞘明显缩短了清石时间,降低了残石发生率,提高了手术清石效率,缩短了总手术时间,降低了麻醉风险,值得临床推广。

Objective To introduce a new method for clearing stone in percutaneous nephrolithotomy （PCNL）, andexplore the efficacy and safety of negative pressure clear stone sheath in PCNL. Methods A total of 73 patients whounderwent PCNL in the First People＇s Hospital of Xianyang City and Xi＇an XD Group Hospital with close stone load fromMarch 2017 to March 2018 were divided into two groups according to whether or not to apply negative pressure stonesheath. Thirty-six cases of patients in the observation group were used negative pressure clear stone sheath, and 37 casesof patients in the control group were used conventional Peel-away sheath. F18 puncture channel was established in bothgroups. The stone clearing time, the incidences of intraoperative and postoperative complications were observed in bothgroups. Results In the observation group, there were 28 patients of the clearing stone time 〈 25 min, which wassignificantly more than 11 patients in the control group（P〈0.05）. There were no significant differences in the incidences ofintraoperative complications between the two groups（P〉0.05）. The incidence of residual stones in the observation group wassignificantly lower than that in the control group （P〈0.05）. Conclusion The negative pressure clear stone sheath obviouslyshortens the time of clearing stone, reduces the incidence of residual stone, improves the efficiency of the clearing stone ofoperation, shortens the total operation time, reduces the risk of anesthesia, and is worthy of clinical promotion.