经皮肾镜取石术中低体质量指数的上尿路结石患者发生并发症的原因分析

Cause analysis of complications in patients with upper urinary calculi with low body mass index during percutaneous nephrolithotripsy

目的探讨低体质量指数的上尿路结石患者行经皮肾镜取石术(PCNL)发生并发症的原因及预防措施。方法选取2012年9月至2019年12月于该院行PCNL治疗的低体质量指数的上尿路结石患者105例作为研究对象,分析低体质量指数的上尿路结石患者术后并发症发生的原因及预防措施。结果研究对象中有6例患者因术中出现呃逆而中止手术,1周后行2次碎石;3例于PCNL中出现了腹腔间隙综合征、血压下降、心率加快等休克症状,经气管插管、利尿、呼吸机辅助呼吸、抗炎等综合治疗后好转。结论低体质量指数的上尿路结石患者手术耐受性较差,应密切监测患者生命体征,尽量缩短手术时间,以避免严重并发症的发生。

Objective To investigate the causes and preventive measures of complications of percutaneous nephrolithotripsy(PCNL)in patients with upper urinary calculi with low body mass index(BMI).Methods A total of 105 patients with upper urinary tract calculi with low body mass index(BMI)who received PCNL treatment in a hospital from September 2012 to December 2019 were selected as research subjects,and the causes of postoperative complications and preventive measures in patients with low BMI upper urinary tract calculus were analyzed.Results Among the subjects,6 patients were discontinued due to hiccup during the operation,and were treated with lithotripsy twice a week later.Three patients developed abdominal space syndrome,blood pressure drop,heart rate increase and other shock symptoms in PCNL,which were improved after combined treatment of endotracheal intubation,diuresis,ventilator assisted breathing and anti-inflammatory.Conclusion Patients with low body mass index of upper urinary tract calculi have poor surgical tolerance,so it is necessary to closely monitor the patients′vital signs and shorten the operative time to avoid serious complication.