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

发布时间：2018-05-04 19:22

  本文选题：肾结石 + 经皮肾镜取石术　； 参考：《中华医院感染学杂志》2016年19期

【摘要】：目的研究经皮肾镜取石术中不同灌注压力对于术后患者感染状态及肾功能的影响,为临床上灌注压力的选择提供依据。方法回顾性分析2014年10月-2015年10月在医院行经皮肾镜取石术70例患者临床资料,其中高灌注压力组患者33例,低灌注压力组患者37例,比较两组患者手术前后生命体征、休克指数、血白细胞计数、中性粒细胞百分率、血肌酐浓度等的差异。结果高灌注压力组患者术后24、48、72h的体温、中性粒细胞百分率、血肌酐浓度均高于低灌注压力组,差异有统计学意义(P0.05);高灌注压力组患者术后24、48h休克指数高于低灌注压力组,差异有统计学意义(P0.05),而术后72h两组患者休克指数差异无统计学意义;两组患者术后24、48、72h脉率、收缩压、血白细胞计数差异均无统计学意义。结论高灌注压力组患者术后体温、中性粒细胞百分率、血肌酐浓度、休克指数均高于低灌注压力组,即高灌注压力组患者术后感染状态更加严重,肾功能损害也相对严重,而术后72h两组患者的休克指数相比差异无统计学意义,这说明随着术后补液、抗感染等治疗措施的实施,患者感染减轻,逐渐好转。
[Abstract]:Objective to study the effect of different perfusion pressure on the infection status and renal function during percutaneous nephrolithotomy, and to provide evidence for clinical selection of perfusion pressure. Methods the clinical data of 70 patients undergoing percutaneous nephrolithotomy from October 2014 to October 2015 were analyzed retrospectively, including 33 patients in high perfusion pressure group and 37 patients in low perfusion pressure group. The vital signs before and after operation were compared between the two groups. Shock index, white blood cell count, neutrophil percentage, serum creatinine concentration, etc. Results the body temperature, percentage of neutrophils and serum creatinine concentration in the high perfusion pressure group were significantly higher than those in the low perfusion pressure group at 24: 48 h, and the shock index was higher in the high perfusion pressure group than in the low perfusion pressure group at 2448 hours after operation. There was no significant difference in shock index between the two groups at 72 hours after operation, but there was no significant difference in pulse rate, systolic blood pressure and white blood cell count between the two groups at 24: 48 and 72 hours after operation. Conclusion the postoperative body temperature, percentage of neutrophils, serum creatinine concentration and shock index in the high perfusion pressure group were higher than those in the low perfusion pressure group, that is, the postoperative infection status and renal function damage were more serious in the high perfusion pressure group than in the low perfusion pressure group. However, there was no significant difference in shock index between the two groups at 72 hours after operation, which indicated that with the implementation of post-operative rehydration, anti-infection and other treatment measures, the infection of the patients decreased and gradually improved.
【作者单位】： 中山大学附属第三医院生殖医学中心;中山大学附属第三医院岭南医院泌尿外科;
【基金】：广东省自然科学基金资助项目(S2013040014333)
【分类号】：R699.2
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本文编号：1844332