负压吸引鞘在感染性肾结石PCNL术中的应用体会

Application of negative pressure suction sheath in PCNL operation for infectious renal calculi

目的分析负压吸引鞘在经皮肾镜取石术中治疗感染性肾结石的安全性和有效性。方法回顾性分析260例行经皮肾镜治疗感染性肾结石的患者的临床资料,将患者分为2组,负压吸引鞘组(A组)和Peel-away组(B组),比较2组结石清除率、手术时长、术后发热(T>38.5℃)情况、炎症指标(白细胞、感染三项)、术后住院时间。结果手术时长A组(40.2±2.1)min,B组(60.7±3.6)min;A组住院时间(5.4±0.7)d,B组(6±0.9)d;术后发热A组9例,B组23例;术后A组炎症指标均低于B组;A组结石清除率为97.1%,B组结石清除率为90.3%。差异均具有统计学意义(P<0.05)。结论负压吸引鞘在经皮肾镜治疗感染性肾结石中,具有安全、有效、结石清除率高、手术时间短、术后并发症少、术后恢复快等优点,具有很高的临床应用价值,值得在临床推广。

Objective This paper analyzes the safety and effectiveness of negative pressure suction sheath in the treatment of infectious renal calculi during percutaneous nephrolithotomy.Methods The clinical data of 260 patients underwent percutaneous nephrolithotomy for patients with renal stones were retrospectively analyzed.The patients were divided into two groups,negative pressure suction sheath(group A)and peel-away(group B),compared the stone clearance rate,operative duration,postoperative fever(T>38.5℃),inflammatory index(white blood cells,three terms of infection),and length of postoperative hospital stay for two groups.Results The result showed that the surgical duration was(40.2±2.1)min in group A and(60.7±3.6)min in group B.The length of hospital stay was(5.4±0.7)days in group A,and(6±0.9)days in group B.There were 9 cases of postoperative fever in group A and 23 cases in group B.The postoperative inflammatory indexes in group A were lower than that in group B.The stone clearance rate in group A was 97.1%,and the stone clearance rate in group B was 90.3%.There was statistically significance in difference(P<0.05).Conclusions Negative pressure suction sheath has the advantages of safety,effectiveness,high stone clearance rate,short operation time,less postoperative complications,quick postoperative recovery in percutaneous nephrolithoscopic treatment of infectious kidney stones.So it has high clinical application value,and is worthy of clinical recommendation.