摘要
目的探讨微创经皮肾镜取石术（MPCNL）术中肾盂内压变化对术后发热的影响。方法采用压力传感器实时测量80例MPCNL手术患者肾盂内压，采用Logistic回归分析统计肾盂内压等因素变化与术后发热的关系。结果80例患者术中平均肾盂内压14．72mmHg（1mmHg=0．133kPa），肾盂内压≥30mrnHg平均累积时间为116．06S，术后出现体温≥38．5℃者15例。Logistic回归分析显示，术后发热与性别（P：0．195）、年龄（P=0．641）、尿路感染（P=0．663）、术后血常规白细胞≥10×10^9／L（P=0．751）、术中肾盂内压曾≥40mmHg（P=0．662）不相关，而与感染性结石（P=0．000）、通道大小（P=0．029）、术中平均肾盂内压（P=0．036）、术中平均肾盂内压≥20mmHg（P=0．013）、肾盂内压≥30mmI-Ig时间（P=0．010）相关，术中肾盂内压≥30mmHg状态持续50S以上者术后发热率发生显著增高（P=0．024）。结论MPCNL术中肾盂内压总的趋势小于一般认为引起肾实质反流的极限（30mmHg）。术后发热与MPCNL导致的肾盂内压短暂性增高不相关，但肾盂内压≥30mmHg状态持续〉50S、总平均肾盂内压升高将引起术后发热发生率增高。
Objective To investigate the renal pelvic pressure（RPP） during minimally invasive percutaneous nephrolithotomy（MPCNL）, and inspect its influence to postoperative fever. Methods The RPP was measured by baroceptor, and these data about pressure and postoperative fever were evaluated statistically. Results The mean RPP was 14.72 mm Hg, the mean accumulative time of RPP≥30 mm Hg was 116.06 s. Fifteen cases（18.75%）had a postoperative fever. Logistical analysis suggested that postoperative fever did not correlate to sex（P=0. 195）, age（P=0. 641）, urinary tract infection （P= 0. 663）, white blood cell≥10 × 10^9/L in blood routine examination postoperatively （P= 0. 751）, once an occurrence of RPP≥40 mm Hg（P = 0. 662）, while infection calculi （P = 0. 000）, percutaneous tract size（P：0. 029） , mean RPP（P=0. 036） ,mean RPP≥20 mm Hg（P=0. 013）, ac cumulative time of RPP≥30 mm Hg（P=0. 010） and RPP≥30 mm Hg longer than 50 s（P=0. 024） contributed to postoperative fever. Conclusions Renal pelvic pressure generally remains lower than a level to back-flow （30 mm Hg） during MPCNL. A transient renal pelvic pressure≥30 mm Hg don＇t countribute to postoperative fever, while a temporary high pressure status（50 s）would had an accumu lated effect which means an enough back-flow to bring a fever.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2008年第10期668-671,共4页
Chinese Journal of Urology
关键词
肾造口术
经皮
肾盂内压
发热
Nephrostomy, percutaneous
Renal pelvic pressure
Fever
作者简介
通信作者：钟文，Email：gzgyzhongwen@163．com.
