摘要
目的:分析微通道和标准通道经皮肾镜碎石术对肾结石患者血流动力学和血气分析的影响。方法:选取本院2016年1月至2018年6月80例肾结石患者,均行经皮肾镜碎石术,分为A组采取微通道,B组采取标准通道,两组各40例。比较两组患者灌流液量、手术时间及不同时间点血流动力学和动脉血气分析指标的差异。结果:B组灌流液量较A组明显减少,手术时间较A组明显缩短(P<0.01)。两组患者在不同时间点时心率(HR)的组内比较,并无明显差异(P>0.05);两组灌流前(T2)中心静脉压(CVP)及平均动脉压(MAP)较麻醉前(T1)均明显减少(P<0.05),灌流10min(T3)与灌流前(T2)CVP及MAP的比较,并无明显差异(P>0.05);灌流30min(T4)、灌流60min(T5)及术后(T6)CVP及MAP较T2均明显增高(P<0.05);两组患者在不同时间点时HR、CVP及MAP的组间比较,并无明显差异(P>0.05)。两组术后(t3)剩余碱(BE)、pH、K^+较麻醉前(t1)均明显下降(P<0.05);在不同时间点时,两组患者pH、K^+、BE的组间比较,并无明显差异(P>0.05)。两组患者并发症发生率的比较,并无明显差异(P>0.05)。结论:行经皮肾镜碎石术治疗的肾结石患者灌流液的吸收随着手术时间的增加,其对动脉血气分析及血流动力学的影响亦逐渐明显;因器官功能的代偿,标准通道与微通道经皮肾镜碎石术导致灌流液吸收量的不同,并不会引起患者动脉血气分析及血流动力学的明显差异。
Objective: To analyze the effects of microchannel and standard channel percutaneous nephrolithotomy on hemodynamics and blood gas analysis in patients with renal calculus. Methods: 80 cases of renal calculus in our hospital from January 2016 to June 2018 were treated by percutaneous nephrolithotomy. They were divided into group A with microchannel and group B with standard channel, with 40 cases in each group. The perfusion volume, operation time, hemodynamics and arterial blood gas analysis indexes were compared between the two groups. Results: The perfusion volume in group B was significantly lower than that in group A, and the operative time was significantly shorter than that in group A (P<0.01). There was no significant difference in heart rate (HR) between the two groups at different time points (P> 0.05);central venous pressure (CVP) and mean arterial pressure (MAP) before perfusion (T2) were significantly lower than those before anesthesia (T1)(P< 0.05), and there was no significant difference in CVP and MAP between perfusion 10 minutes (T3) and pre-perfusion (T2)(P> 0.05);30 minafter perfusion (T4), 60 minafter perfusion (T5) and postoperative (T6) CVP and MAP were significantly higher than those of T2 (P< 0.05);HR, CVP and MAP were not significantly different between the two groups at different time points (P> 0.05). The base excess (BE), pH and K^+ of the two groupsafter operation (t3) were significantly lower than those before anesthesia (t1)(P<0.05);there was no significant difference in pH, K^+, BE between the two groups at different time points (P> 0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: With the increase of operation time, the absorption of perfusate in patients with renal calculus treated by percutaneous nephrolithotomy has obvious influence on arterial blood gas analysis and hemodynamics, and because of the compensation of organ function, the difference of perfusion fluid absorption between standard channel and microchannel percutaneous nephrolithotomy does not cause significant difference in arterial blood gas analysis and hemodynamics.
作者
焦常宝
吴齐
徐兵
仰光
王正跃
JIAO Changbao;WU Qi;XU Bing(The First People's Hospital of Chuzhou, Anhui Chuzhou 239000, China)
出处
《河北医学》
CAS
2019年第6期886-890,共5页
Hebei Medicine
基金
安徽省自然科学基金项目,(编号:1608085MH134)
关键词
肾结石
经皮肾镜碎石术
标准通道
微通道
血流动力学
Renal calculus
Percutaneous nephrolithotomy
Standard channel
Microchannel
Hemodynamics
作者简介
通讯作者:吴齐.
