经皮肾镜取石术后常规夹闭肾造瘘管的必要性研究

发布时间：2018-05-04 10:05

本文选题：泌尿系结石 + 经皮肾镜取石术　；参考：《中国微创外科杂志》2017年02期

【摘要】：目的探讨经皮肾镜取石(percutaneous nephrolithotomy,PCNL)术后是否有必要常规夹闭肾造瘘管以及合适的夹闭时间。方法 2011年9月~2012年2月将符合入选标准的80例PCNL随机分成4组,每组20例:A组,PCNL术后开放肾造瘘管;B组,术后夹闭肾造瘘管0.5 h;C组,术后夹闭肾造瘘管1 h;D组,术后夹闭肾造瘘管2 h。比较4组患者术后血红蛋白(Hb)降低值、止痛药用量、术后发热、肾周积液、肾造瘘管留置时间及术后住院时间等指标。结果术后Hb降低值A组(11.3±6.7)g/L,B组(11.4±6.8)g/L,C组(9.2±6.7)g/L,D组(12.8±9.6)g/L,4组差异无统计学意义(F=0.772,P=0.516);哌替啶用量A组(67.5±29.4)mg,B组(75.0±34.4)mg,C组(80.0±37.7)mg,D组(77.5±34.3)mg,差异无统计学意义(F=0.502,P=0.682)。术后发热A组5例,B组3例,C组3例,D组2例,4组间差异无统计学意义(χ~2=1.745,P=0.627);肾周积液A组0例,B组4例,C组5例,D组5例,4组间差异无统计学意义(χ~2=5.887,P=0.117)。肾造瘘管留置时间A组(4.4±1.2)d,B组(4.3±1.3)d,C组(4.5±1.2)d,D组(4.4±1.5)d,4组间差异无统计学意义(F=0.078,P=0.972)。住院时间A组(5.2±1.4)d,B组(5.3±1.2)d,C组(5.5±1.6)d,D组(5.3±1.3)d,差异无统计学意义(F=0.170,P=0.919)。结论经皮肾镜取石术后没有必要常规夹闭肾造瘘管,肾造瘘管夹闭与否对患者的恢复无明显影响。
[Abstract]:Objective to investigate the necessity of conventional occlusion of nephrostomy tube and appropriate clamping time after percutaneous nephrolithotomy (percutaneous nephrolithotomy, PCNL). Methods in February September 2011, 80 cases of PCNL were randomly divided into 4 groups, 20 cases in each group: A group, open renal fistulae after PCNL, B, and 0.5 h after operation. Group C, 1 h after operation, group D, group D and 2 h. After operation, the decrease value of hemoglobin (Hb) after operation, analgesic dosage, postoperative fever, perirenal effusion, renal fistula retention time and postoperative hospitalization time and so on. Results after operation, Hb decreased in A group (11.3 + 6.7) g/L, B group (11.4 + 6.8) g/L, C group (9.2 + 6.7) g/L, 12.8 9.6) g/L, there was no significant difference in the 4 groups (F=0.772, P=0.516); the amount of pethidine used in group A (67.5 + 29.4) Mg, B group (75 + 34.4) Mg, C group (80 + 37.7) Mg, D group (77.5 + 34.3) Mg, there was no significant difference (F=0.502,). There were 0 cases in group A, 4 in group B, 5 in group C and 5 in group D. The difference between the 4 groups was not statistically significant (4.4 + 1.2) d, B group (4.3 + 1.3) d, C group (4.5 + 1.2) d, there was no significant difference between the two groups. .3) d, the difference was not statistically significant (F=0.170, P=0.919). Conclusion there is no need for conventional occlusion of renal fistulae after percutaneous nephrolithotomy, and the renal fistula closure has no significant effect on the recovery of the patients.

【作者单位】：北京大学人民医院泌尿外科;
【分类号】：R699

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