摘要
目的探讨标准通道新型标准肾镜联合EMS第四代碎石清石系统经皮肾镜取石术中肾盂内压变化及相关因素。方法采用F18新型标准肾镜联合EMS第四代碎石清石系统对210例肾结石患者行经皮肾镜取石术,随机分为F22通道组及F24通道组,两组各105例。通过逆行置入肾盂的F6输尿管导管连接测压系统,监测210例术中肾盂内压的变化。结果 F22通道组、F24通道组术中平均肾盂内压分别为(28.26±7.32)cmH_2O、(22.51±9.54)cmH_2O(1cmH_2O=0.098kPa)(P<0.05),术中可出现短暂肾盂高压状态,术后脓毒血症F22组4例,F24组3例。术后第3天血红蛋白较术前下降:F22组平均(7.4±2.3)g/L,F24组平均(8.1±3.1)g/L(P>0.05)。结论 F18新型标准肾镜联合EMS第四代碎石清石系统配合F22或F24通道PCNL术中平均肾盂内压处于较低水平,但操作不当及冲洗与负压控制配合不好可导致术中肾盂高压。
Objective To explore the influence of standard channel of new type standard nephroscope combined with fourth-generation EMS lithotripsy system on the internal pressure changes of the renal pelvis and the related factors in percutaneous nephrolithotomy （PCNL）. Methods The F18 new standard nephroscope combined with fourth-generation EMS lithotripsy system for PCNL was used in 210 cases of kidney stones. The patients were randomly divided into two groups, the F22 channel group and F24 channel group, with 105 cases in each group. The changes of pressure were measured. Results The average intraoperative renal pelvis internal pressure was （8.26±7.32） and （22.51±9.54） cmH2O in the F22 and F24 channel groups respectively （P～0.05, 1 cmH2O=0. 098 kPa）. A brief high renal pelvis pressure was recorded during the operation. Postoperative sepsis was found in 4 cases and 3 cases in the F22 and F24 channel groups. Compared with that pre-operation, the hemoglobin decreased 3 days after operation to （7.4±2.3）g/L for in the F22 channel group and （8.6±5. 1）g/L in the F24 channel group （P〉0.05）. Conclusion The average intraoperative renal pelvis internal pressure remained low when F18 new standard nephroscope combined with fourth-generation EMS lithotripsy system was used. Improper operation and coordination between flush and negative pressure control may result in high renal pelvis pressure.
出处
《现代泌尿外科杂志》
CAS
2016年第10期768-771,共4页
Journal of Modern Urology
关键词
经皮肾镜取石术
EMS
肾盂内压
percutaneous nephrolithotomy
EMS
Renal pelvis internal pressure
作者简介
曾鹏（1979-），男（汉族），医学硕士，副主任医师．研究方向：泌尿系结石、肿瘤．E-mail：zpstore2002@163．com
