微通道经皮肾镜术后气囊导尿管牵拉止血作用的临床研究
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摘要
目的：观察临床应用气囊导尿管牵拉法对mPCNL术后出血的疗效,从而寻找对(?)nPCNL术后出血较好的预防措施,为临床治疗提供参考。
方法：自2010-11月至2011年04月,前瞻性收集中南大学湘雅医院泌尿外科明确诊断为上尿路结石且应用mPCNL治疗的88例患者的临床资料进行研究。随机将病例资料分为：对照组：气囊导尿管不牵拉组、实验组：气囊导尿管牵拉止血组。通过氰化高铁血红蛋白法测量出血量。使用Wilcoxon秩和检验的统计学方法,分析两组出血量的关系,从而对使用气囊导尿管牵拉止血方法的作用进行探讨。
结果：本组资料88例患者中86例采用单通道单侧取石术,2例采用两通道单侧取石,手术全部成功,无中转放手术及术后迟发性大出血病例,术后无输血治疗及选择性肾动脉栓塞病例。术后对照组平均出血量为13.82638g,出血时间为4天；实验组平均出血量为7.9587g,出血时间为3天。经Wilcoxon秩和检验,P<0.001,具有明显统计学差异。
结论：对于mPCNL术后出血施行气囊导尿管牵拉压迫止血能够明显减少术后出血量,实验证实有效、临床观察可行。
Objective:
Renal hemorrhage is one of the most common and worrisome complications of post-percutaneous nephrolithotomy.This study aimed at evaluating the safety、effectiveness、and feasibility of utilization of the Foley catheter strained for hemorrhage of post-microchannel Percuta-neous Nephrolithotomy.
Methods:
88 Patients were collected prospectively at urology department of CSU XIANGYA Hospital during november 2010 to June 2011 with upper urinary calculi undergoing mPCNL procedures,and divided into two groups randomly.one group(45patients) with 16F Foley catheter unstrained as nephrostomy,another group (43patients) with 16F Foley catheter strained. Blood loss was estimated based on the the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN.Blood loss and bleeding time were compared in 2 groups with Wilcoxon rank sum test.
RESULTS:
The average blood loss was 13.82638g and 7.957g (P<.001). The mean bleeding time was 4 and 3days (P<.002), A statistically significant difference was found.
CONCLUSIONS:
Utilizing the Foley catheter strained for hemorrhage of post-microchannel Percutaneous Nephrolithotomy is a safe、effective and feasible method.
方法：自2010-11月至2011年04月,前瞻性收集中南大学湘雅医院泌尿外科明确诊断为上尿路结石且应用mPCNL治疗的88例患者的临床资料进行研究。随机将病例资料分为：对照组：气囊导尿管不牵拉组、实验组：气囊导尿管牵拉止血组。通过氰化高铁血红蛋白法测量出血量。使用Wilcoxon秩和检验的统计学方法,分析两组出血量的关系,从而对使用气囊导尿管牵拉止血方法的作用进行探讨。
结果：本组资料88例患者中86例采用单通道单侧取石术,2例采用两通道单侧取石,手术全部成功,无中转放手术及术后迟发性大出血病例,术后无输血治疗及选择性肾动脉栓塞病例。术后对照组平均出血量为13.82638g,出血时间为4天；实验组平均出血量为7.9587g,出血时间为3天。经Wilcoxon秩和检验,P<0.001,具有明显统计学差异。
结论：对于mPCNL术后出血施行气囊导尿管牵拉压迫止血能够明显减少术后出血量,实验证实有效、临床观察可行。
Objective:
Renal hemorrhage is one of the most common and worrisome complications of post-percutaneous nephrolithotomy.This study aimed at evaluating the safety、effectiveness、and feasibility of utilization of the Foley catheter strained for hemorrhage of post-microchannel Percuta-neous Nephrolithotomy.
Methods:
88 Patients were collected prospectively at urology department of CSU XIANGYA Hospital during november 2010 to June 2011 with upper urinary calculi undergoing mPCNL procedures,and divided into two groups randomly.one group(45patients) with 16F Foley catheter unstrained as nephrostomy,another group (43patients) with 16F Foley catheter strained. Blood loss was estimated based on the the mass of hemoglobin in the draining liquid and urine during postoperative duration through the HiCN.Blood loss and bleeding time were compared in 2 groups with Wilcoxon rank sum test.
RESULTS:
The average blood loss was 13.82638g and 7.957g (P<.001). The mean bleeding time was 4 and 3days (P<.002), A statistically significant difference was found.
CONCLUSIONS:
Utilizing the Foley catheter strained for hemorrhage of post-microchannel Percutaneous Nephrolithotomy is a safe、effective and feasible method.
引文
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