负压清石鞘降低经皮肾镜碎石术后感染相关并发症发生率分析

Effect of negative pressure lithotomy on the incidence of infection related complications after percutaneous nephrolithotripsy

目的观察负压清石鞘在降低经皮肾镜碎石术后感染相关并发症的效果。方法选择浙江中医药大学附属第一医院2017年1月至2018年12月收治的拟行经皮肾镜碎石术的肾结石患者142例,按随机数字表法分为对照组(71例)和试验组(71例),对照组患者在经皮肾镜碎石术中采用普通鞘,试验组在经皮肾镜碎石术中采用负压清石鞘,两组均术后随访1年,统计复发情况,比较两组围手术期相关指标、术中并发症发生率、术后并发症发生率、随访1年复发率和术后及随访1年时生命质量情况。结果两组患者手术时间比较差异无统计学意义(P>0.05)。试验组患者术中出血量少于对照组[(12.15 ± 1.06)ml比(13.03 ± 1.17)ml],住院时间短于对照组[(5.13 ± 0.67)d比(6.02 ± 0.78)d],差异有统计学意义(P<0.01)。两组术中并发症发生率比较差异无统计学意义(P>0.05)。试验组术后并发症发生率低于与对照组[1.41%(1/71)比11.27% (8/71)],随访1年复发率也低于对照组[1.14%(1/71)比9.86%(7/71)],差异有统计学意义(P<0.05)。两组患者术后世界卫生组织生存质量简表(WHOQOL - BREF)评分比较差异无统计学意义(P>0.05);随访1年时两组患者WHOQOL-BREF评分均升高,其中试验组WHOQOL-BREF各项评分均高于对照组,差异有统计学意义(P<0.01)。结论在经皮肾镜碎石术中以负压清石鞘辅助,可明显降低术后并发症发生率,缩短患者住院时间,并降低患者随访复发,改善患者的生命质量。

Objective To observe the incidence of infection related complications after percutaneous nephrolithotripsy.Methods One hundred and forty-two patients with renal calculi who were treated in the First Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from January 2017 to December 2018 were divided into control group(71 cases)and experimental group(71 cases)by random number method.Among them,the control group was treated with common sheath,the experimental group was treated with negative pressure lithotomy,and the patients were followed up for 1 year after the operation to count the recurrence.The patients in the two groups were compared in terms of perioperative indexes,intraoperative complication rate,postoperative complication rate,recurrence rate in 1 year′s follow-up and quality of life in 1 year′s follow-up.Results The operation time in two groups had no significant difference(P>0.05).The amount of bleeding in the experimental group was significantly higher than that in the control group[(12.15±1.06)ml vs.(13.03±1.17)ml],the length of hospitalization was significantly shorter than that in the control group[(5.13±0.67)d vs.(6.02±0.78)d],and the differences were statistically significant(P<0.01).The incidence of intraoperative complications in two groups had no significant difference(P>0.05).The incidence of postoperative complications in the experimental group was significantly lower than that in the control group[1.41%(1/71)vs.11.27%(8/71)],the recurrence rate in the follow-up period of 1 year was significantly lower than that in the control group[1.14%(1/71)vs.9.86%(7/71)],and the differences were statistically significant(P<0.05).The scores of postoperative World Health Organization Quality of Life Questionaire BREF(WHOQOL-BREF)of the two groups had no significant difference(P>0.05).At 1 year′s follow-up,the scores of WHOQOL-BREF in the experimental group were significantly higher than those in the control group(P<0.01).Conclusions With the help of vacuum lithotripsy in percutaneous nephrolithotripsy,but the incidence of postoperative complications can be significantly reduced,the length of stay can be shortened,the follow-up recurrence can be reduced,and the quality of life can be improved.