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肾盂内压力监测在不同通道下行经皮肾镜取石术治疗鹿角形肾结石的临床研究

Clinical study of intrapelvic pressure monitoring in percutaneous nephrolithotomy of different channel in treatment of renal staghorn calculi

:30-33
 
目的 不同通道下的经皮肾镜取石术肾盂压力监测治疗鹿角形肾结石的临床分析。方法 选取我院2016年1月–2017年12月收治的鹿角形肾结石患者120例,通过随机分组,分别采用16F、18F、20F、22F、24F 作为手术通道,在气管插管全麻下置入8/9.8F 输尿管镜行经皮肾镜气压弹道碎石取石术,行经皮肾镜取石术,术中通过监测输尿管导管的压力,即肾盂内压并记录。测压系统每秒钟采集一次数据并录入数据库。观察不同通道下肾盂内压力以及取石速度。结果 在24F通道下肾盂内压力最低,与其他通道组进行比较,差异有统计学意义(P<0.05);肾盂内压力大于40 cmH2O时在24F通道下取石速度最短,与其他通道组进行比较,差异有统计学意义(P<0.05);24F通道与22F通道下取石速度最快,与其他通道组进行比较,差异有统计学意义(P<0.05)。结论 肾盂内压监测使经皮肾镜取石术更加安全和精确,值得临床进一步推广应用。
Objective To investigate the pyelolithic pressure monitoring in percutaneous nephrolithotomy of different channel in treatment of renal staghorn calculi. Methods 120 patients of staghorn renal calculi in our hospital were selected from January 2016 to December 2017. These patients were randomly divided into 5 groups according to the operation channel(16F,18F,20f,22F,24F). During operation,renal pelvis,ureter catheter pressure and operation time were recorded. Results The lowest renal pelvis pressure could be found in the 24F channel and the difference was statistically significant(P<0.05). The lowest operation time could be found in the condition of the renal pelvis pressure of more than 40cmH2O and 24F channel(P<0.05). Beside of this, the fastest stone-free rate could be found in 22F and 24F channel(P<0.05). Conclusion Monitoring of renal pelvic pressure makes percutaneous nephroscopic surgery more accurate and safety. It is worthy of clinical application.
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