标准通道与微通道经皮肾镜取石术对肾结石患者术后感染的影响
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摘要
目的探讨标准通道与微通道经皮肾镜取石术对肾结石患者术后感染的影响。方法选取在我院进行治疗的肾结石患者94例,按随机数表法分为对照组与观察组,各47例。对照组行标准通道经皮肾镜取石术治疗,观察组予微通道经皮肾镜取石术治疗,比较两组手术相关指标、肾主动脉血流动力学指标及术后感染和结石清除情况。结果观察组术中出血量及术中输液量均明显少于对照组,手术时间较长,差异有统计学意义(P<0.05);术后30d,观察组肾主动脉收缩期峰值(Vmax)流速、收缩期峰值和舒张期流速比值(S/D)均明显高于对照组,阻力指数(RI)较低,差异有统计学意义(P<0.05);观察组术后感染率明显高于对照组,结石清除率较低,差异有统计学意义(P<0.05)。结论与标准通道相比,微通道经皮肾镜取石术可减少肾结石患者术中出血量,改善肾主动脉血流,但其手术时间较长,结石清石率较低,且术后感染率较高。
Objective To investigate the influence of standard passage and micro channel percutaneous nephrolithotomy on postoperative infection in patients with renal calculi. Methods 94 patients with renal calculi patients who were treated in our hospital were selected and randomly divided into control group and observation group,47 cases in each.The control group was treated by standard percutaneous nephrolithotomy,and the observation group was treated by micro channel percutaneous nephrolithotomy.The operative indexes,the hemodynamic indexes of the renal artery,the postoperative infection and the removal of calculi were compared between the two groups. Results The intraoperative blood loss and intraoperative infusion volume in the observation group were significantly less than those in the control group,and the operation time was longer,the difference was statistically significant(P < 0.05);30 days after operation,the renal artery peak systolic velocity(Vmax),peak systolic and diastolic velocity ratio(S/D) of the observation group were significantly higher than that of the control group,the resistance index(RI) was lower,the difference was statistically significant(P < 0.05);The postoperative infection rate of the observation group was higher than that of the control group,and the stone clearance rate was lower,the difference was statistically significant(P< 0.05). Conclusion Compared with the standard channel,micro channel percutaneous nephrolithotomy can reduce bleeding in patients with renal calculi,improve renal aortic blood flow,but the operation time is longer,stone stone clearance rate is low,and the postoperative infection rate.
Objective To investigate the influence of standard passage and micro channel percutaneous nephrolithotomy on postoperative infection in patients with renal calculi. Methods 94 patients with renal calculi patients who were treated in our hospital were selected and randomly divided into control group and observation group,47 cases in each.The control group was treated by standard percutaneous nephrolithotomy,and the observation group was treated by micro channel percutaneous nephrolithotomy.The operative indexes,the hemodynamic indexes of the renal artery,the postoperative infection and the removal of calculi were compared between the two groups. Results The intraoperative blood loss and intraoperative infusion volume in the observation group were significantly less than those in the control group,and the operation time was longer,the difference was statistically significant(P < 0.05);30 days after operation,the renal artery peak systolic velocity(Vmax),peak systolic and diastolic velocity ratio(S/D) of the observation group were significantly higher than that of the control group,the resistance index(RI) was lower,the difference was statistically significant(P < 0.05);The postoperative infection rate of the observation group was higher than that of the control group,and the stone clearance rate was lower,the difference was statistically significant(P< 0.05). Conclusion Compared with the standard channel,micro channel percutaneous nephrolithotomy can reduce bleeding in patients with renal calculi,improve renal aortic blood flow,but the operation time is longer,stone stone clearance rate is low,and the postoperative infection rate.
引文
[1]李建兴,肖博.经皮肾镜取石术在肾结石治疗中的地位[J].临床外科杂志,2017,25(2):89-90.
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[6]白维斌,王永堂.多通道经皮肾镜取石术对肾功能的影响及肾功能减退的危险因素分析[J].现代泌尿外科杂志,2016,21(9):691-693,699.
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[8]钟志刚,潘铁军,李功成.F24通道和F16通道经皮肾镜取石术中肾盂内压的对比研究[J].中华泌尿外科杂志,2016,37(5):354-357.
[9]常丛旺,王学华,赖建平,等.单通道与双通道经皮肾镜取石术治疗复杂性肾结石的疗效对比[J].湖南师范大学学报(医学版),2016,13(4):98-101.
[10]胡德军.经皮肾镜取石术并发症的防治进展[J].国际泌尿系统杂志,2017,37(2):264-266.
[11]王凯,王广健.单通道微创经皮肾镜联合输尿管软镜同期、分期治疗复杂性肾结石的临床研究[J].中国医疗设备,2016,31(11):110-112.
[12]李晓明,李腾成,杨飞,等.经皮肾镜取石术中不同灌注压力对术后患者感染状态及肾功能的影响[J].中华医院感染学杂志,2016,26(19):4485-4487.
[13]许全超,郭亮,张桃福,等.微通道经皮肾镜取石术治疗肾结石502例报道[J].安徽医药,2016,20(2):352-353.
[14]李高飞,张慕淳,张刚,等.“无管化”微通道经皮肾镜取石术治疗上尿路结石68例临床观察[J].国际泌尿系统杂志,2017,37(1):47-50.
[15]张伟,祖雄兵,齐琳,等.微通道与标准通道经皮肾镜取石术治疗复杂性肾结石的比较[J].中国内镜杂志,2015,21(1):34-36.
[2]季武,杨秀书,李荣富,等.肾结石患者经皮肾镜取石术后重症感染病原菌与对肾功能影响机制研究[J].中华医院感染学杂志,2015,25(20):4621-4623.
[3]陈伟,汤春波,齐勇,等.肾上盏入路经皮肾镜取石术治疗上尿路结石92例分析[J].浙江医学,2016,38(5):360-361.
[4]孟凡湘,王圣燕,何晓晨,等.超微创单通道经皮肾镜取石术治疗不复杂结石的临床分析[J].中国内镜杂志,2016,22(12):103-106.
[5]孙翔,习海波.经皮肾镜取石术治疗老年肾结石患者出血的危险因素[J].中国老年学杂志,2016,36(11):2708-2709.
[6]白维斌,王永堂.多通道经皮肾镜取石术对肾功能的影响及肾功能减退的危险因素分析[J].现代泌尿外科杂志,2016,21(9):691-693,699.
[7]王目炜.微创经皮肾镜取石术对复杂性肾结石患者临床效果观察及安全性评价[J].河北医药,2017,39(7):1031-1033.
[8]钟志刚,潘铁军,李功成.F24通道和F16通道经皮肾镜取石术中肾盂内压的对比研究[J].中华泌尿外科杂志,2016,37(5):354-357.
[9]常丛旺,王学华,赖建平,等.单通道与双通道经皮肾镜取石术治疗复杂性肾结石的疗效对比[J].湖南师范大学学报(医学版),2016,13(4):98-101.
[10]胡德军.经皮肾镜取石术并发症的防治进展[J].国际泌尿系统杂志,2017,37(2):264-266.
[11]王凯,王广健.单通道微创经皮肾镜联合输尿管软镜同期、分期治疗复杂性肾结石的临床研究[J].中国医疗设备,2016,31(11):110-112.
[12]李晓明,李腾成,杨飞,等.经皮肾镜取石术中不同灌注压力对术后患者感染状态及肾功能的影响[J].中华医院感染学杂志,2016,26(19):4485-4487.
[13]许全超,郭亮,张桃福,等.微通道经皮肾镜取石术治疗肾结石502例报道[J].安徽医药,2016,20(2):352-353.
[14]李高飞,张慕淳,张刚,等.“无管化”微通道经皮肾镜取石术治疗上尿路结石68例临床观察[J].国际泌尿系统杂志,2017,37(1):47-50.
[15]张伟,祖雄兵,齐琳,等.微通道与标准通道经皮肾镜取石术治疗复杂性肾结石的比较[J].中国内镜杂志,2015,21(1):34-36.