负压清石鞘在经皮肾镜取石术治疗肾结石中的应用价值

Application value of negative pressure lithotripsy sheath in the treatment of renal calculi by percutaneous nephrolithotomy

目的探讨负压清石鞘在经皮肾镜取石术治疗肾结石中的应用价值。方法选取2017年10月~2018年10月我院收治的106例肾结石患者作为研究对象进行回顾性分析,根据术中取石技术的不同,将患者分为对照组与试验组,每组各53例。对照组患者采用Peel-away鞘技术,试验组患者采用负压清石鞘技术。治疗结束后,比较两组患者的清石时间、一期结石清除率及总结石清除率;比较两组患者的术中肾盂内压力水平;比较两组患者的降钙素原(PCT)、血白细胞计数(WBC)、C反应蛋白(CRP)水平;比较两组患者术前、术后的血红蛋白含量;比较两组患者的并发症总发生率。结果试验组患者的清石时间短于对照组,一期结石清除率及总结石清除率均高于对照组,差异有统计学意义(P<0.05)。试验组患者的术中肾盂内压力、PCT、WBC、CRP水平均低于对照组,差异有统计学意义(P<0.05)。试验组患者术后的血红蛋白含量高于对照组,差异有统计学意义(P<0.05)。试验组患者的并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论负压清石鞘在经皮肾镜取石术治疗肾结石患者中的临床效果显著,安全有效,能缩短患者的清石时间,提高患者的结石清除率,降低患者的术中肾盂内压力,减少并发症发生,值得临床应用。

Objective To explore the application value of negative pressure lithotripsy sheath in the treatment of renal calculi by percutaneous nephrolithotomy.Methods A retrospective analysis was performed on 106 patients with renal calculi admitted to our hospital from October 2017 to October 2018 were selected as subjects,and they were divided into control group and experimental group according to the different techniques of intraoperative stone removal,53 cases in each group.The patients in control group were treated with Peel-away sheath technique,and the patients in experimental group were treated with negative pressure lithotripsy sheath technique.After the treatment,the stone removal time,primary stones removal rate and summary stones removal rate of the two groups were compared.Intraoperative intrapelvic pressure was compared between the two groups.The levels of procalcitonin(PCT),white blood cell count(WBC)and C-reactive protein(CRP)in the two groups were compared.The hemoglobin contents of the two groups before and after surgery were compared.The total incidence of complications was compared between the two groups.Results The stone removal time of the experimental group was shorter than that of the control group,and the primary stones removal rate and summary stones removal rate were higher than those of the control group,with statistically significant differences(P<0.05).Intraoperative pressure,PCT,WBC and CRP levels in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).The hemoglobin content after surgery of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total incidence of complications in the experimental group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The clinical effect of negative pressure lithotripsy sheath in percutaneous nephrolithotomy in the treatment of renal calculi is significant and safe.It may be related to shortening the time of lithotripsy,improving the stone clearance rate,reducing intrapelvic pressure and reducing the incidence of complications.It can shorten the time of stone removal,improve the stone removal rate,reduce the intraoperative pressure in the renal pelvis,and reduce the incidence of complications,which is worthy of clinical application.