摘要
目的探讨微通道经皮肾镜取石术(PCNL)中皮肾通道数目对肾盂内压变化的影响。方法通过逆行置入肾盂的6F输尿管导管连接测压系统,保持平均灌注流量346mL/min,平均灌注压196mmHg(1mmHg=0.133kPa),监测102例不同数目通道下PCNL术中肾盂内压的变化,每秒钟采集一次数据,做统计学分析。结果单通道、双通道、三通道以及四通道下PCNL术中平均肾盂内压分别为(31.25±6.52)、(17.51±3.66)、(16.28±3.92)及(14.33±2.71)cmH2O(1cmH2O=0.098kPa)。单通道PCNL术中平均肾盂内压均高于多通道(P<0.001),而双通道、三通道和四通道PCNL术中平均肾盂内压无显著差异(P>0.05)。结论不同数目通道下PCNL术中肾盂内压均较低,小于引起肾实质返流的压力安全值(40cmH2O)。单通道PCNL术中肾盂内压高于多通道,而双通道和三通道、四通道PCNL术中肾盂内压无显著差异。通道数目的选择取决于结石形状及位置,处理铸型结石采用多通道PCNL,可降低因肾盂内高压状态累积致使返流达到一定限度而引起菌血症的风险。
Objective To evaluate the number of access tract that may affect intrapelvic pressure following percutaneous nephrolithotomy（PCNL）.Methods 97 patients who underwent PCNL at our hospital were studied（single tract access,n=70,multiple tract access,n=27）.An open-end 6 F ureteral catheter was inserted into the target ureter.The average irrigation fluid was about 346 mL/min,and average irrigation pressure was 196 mmHg（1 mmHg=0.133 kPa）.Intrapelvic pressures were measured with urodynamic work stations every second,and the data were analyzed and categorized into two groups according to the access number.Results The average intrapelvic pressure of different number of access tract of PCNL such as single tract,two tracts,three tracts,and four tracts were（31.25±6.52）,（17.51±3.66）,（16.28±3.92）and（14.33±2.71）cmH2O（1 cmH2O=0.098 kPa）,respectively.Intrapelvic pressure of single tract access was significantly higher than that of multiple tract access（P0.001）,but there was no difference among multiple tract access（P0.05）.Conclusions Intrapelvic pressures of multiple and single tract access of PCNL were lower than the safety level（40 cmH2O）.The intrapelvic pressure of single tract access of PCNL was higher than that of multiple cases,but there were no significant difference among multiple cases.The numbers of access tracts depended on the size and location of the stones.Multiple access tracts in treating staghorn calculi could decrease the intrapelvic pressure during operation,which could reduce the bacteremia after PCNL.
出处
《现代泌尿外科杂志》
CAS
2012年第1期55-57,共3页
Journal of Modern Urology
作者简介
作者简介：曾鹏（1979-），男（汉族），硕士在读，研究方向为泌尿结石．E—mail：zpstorte2002@163．com.
