摘要
目的观察经皮肾镜碎石术(PCNL)后肾造瘘管与导尿管的不同拔管顺序对患者术后并发症及病情恢复的影响。方法选取我院2014年1月至2016年8月收治的60例双侧或单侧肾结石患者为研究对象,建立标准经皮肾镜手术通道行PCNL术。其中30例患者于术后3~5 d先拔除肾造瘘管,观察病情稳定于肾造瘘管拔除2 d后再拔除导尿管,将其作为研究组;30例患者于术后1~3 d先拔除导尿管,拔除后2 d复查双肾CT可拔除肾造瘘管作为对照组,观察两组患者的下床活动时间以及住院天数,术后恢复期间观察两组的并发症发生情况。结果研究组的首次下床活动时间、住院天数均显著少于对照组,满意度评分显著高于对照组,差异有统计学意义(P<0.05)。研究组的发热、腰痛、重复导尿、尿外渗、肾周穿刺引流、尿道感染的发生率均显著低于对照组,差异有统计学意义(P<0.05);两组的肾功能损害发生率差异无统计学意义(P>0.05)。结论 PCNL术后先拔除肾造瘘管再拔除导尿管的方法安全可行,可有效促进患者的病情康复,值得临床借鉴。
Objective To observe the influence of extubation sequence of nephrostomy tube and urethral catheter after percutaneous nephrolithotripsy（PCNL） on the postoperative complications and recovery of disease. Methods 60 cases of patients with unilateral or bilateral kidney stones admitted to our hospital from January 2014 to August 2016 were selected as research objects and divided into two groups. All patients received PCNL with standard channel. 30 cases of study group removed nephrostomy tube 3-5 days after surgery,and removed urethral catheter 2 days later. 30 cases of control group removed urethral catheter 1-3 d after surgery,and removed nephrostomy tube 2 days later. The evacuation active time,days of hospitalization,and incidence of complications during recovery period were observed.Results The evacuation active time and days of hospitalization of study group were significantly shorter than those of control group,and the score of satisfaction degree was significantly higher than that of control group（all P〈0.05）. The incidences of fever,lumbago,repeated catheterization,urinary extravasation,perirenal puncture drainage and urinary tract infection of study group were significantly lower than those of control group（all P〈0.05）,while no statistical difference was found between two groups in the incidence of renal function damage（P〉0.05）. Conclusions The extubation sequence with nephrostomy tube first and urethral catheter later after PCNL is safe and feasible,which can effective promote the recovery of patents＇ condition,and is worthy of clinical reference.
出处
《临床医学工程》
2017年第4期487-488,共2页
Clinical Medicine & Engineering
关键词
经皮肾镜碎石术
肾造瘘管
导尿管
并发症
拔管顺序
Percutaneous nephrolithotripsy（PCNL）
Nephrostomy tube
Urethral catheter
Complications
Extubation sequence
