摘要
目的探讨不同灌注方法(自动压力泵灌注法和自由重力灌注法)对输尿管镜碎石术围手术期指标的影响。方法回顾性分析2018年1—9月宁夏医科大学第二附属医院收治的150例输尿管结石患者的病例资料,其中男性86例,女性64例;年龄23~75岁,中位年龄为47岁。根据术中使用灌注方法不同将患者分为自动压力泵灌注组和自由重力灌注组,每组各75例。对比两组患者的手术时间、手术前后血清白细胞计数升高值及血肌酐升高值、结石上移发生率、结石残留率、术中及术后并发症发生率。计量资料以均数±标准差(Mean±SD)表示,组间比较采用t检验;计数资料组间比较采用χ2检验。结果自动压力泵灌注组患者的手术时间短于自由重力灌注组[(42.20±17.61)min比(45.23±16.40)min],但术后血清白细胞计数升高值[(3.83±3.01)×109/L比(4.36±2.97)×109/L]、第1天血肌酐水平升高值不如自由重力灌注组明显[(63.26±12.46)μmol/L比(65.64±11.10)μmol/L],差异均具有统计学意义(P=0.034、0.011、0.002)。自动压力泵灌注组和自由重力灌注组患者的结石上移发生率(5.3%比9.3%)、结石残留率(2.7%比4.0%)、术中输尿管黏膜发病率(12.0%比10.7%)及术后并发症发生率(泌尿道感染:4.0%比5.3%,轻度肾积水:5.3%比6.7%)比较,差异均无统计学意义(P=0.347、0.649、0.797、0.868)。结论与自由重力灌注相比,在输尿管镜碎石术中使用自动压力泵灌注可以减少手术时间,自动压力泵可以减少术后血清白细胞升高值及血肌酐升高值。2种不同灌注方法对结石上移率、结石残留率、术中输尿管黏膜损伤发病率、术后肾积水及泌尿道感染发生率的影响没有差异性。
Objective To investigate the effects with perioperative indicators of different irrigation methods(automatic irrigation pump and gravity-based irrigation)on ureteroscopic lithotripsy.Methods A retrospective analysis was used to select 150 patients with ureteral calculi in the Second Affiliated Hospital of Ningxia Medical University from January 2018 to September 2018.The patients included 86 males and 64 females,and the median age was 47 years,ranged 23 to 75 years.The patients were divided into two groups:automatic irrigation pump and gravity-based irrigation group,with 75 cases in each group.The time of operation,the rate of stone moving up,the rate of stone remaining,the change of leukocyte and serum creatinine before and after operation,and the incidence of operation complications were compared between the two groups.The measurement data was expressed as Mean±standard deviation(Mean±SD),and the t-test was used for comparison between groups;the Chi-square test was used for comparison between count data.Results The operative time of automatic irrigation pump was shorter than that of gravity-based irrigation group[(42.20±17.61)min vs(45.23±16.40)min].The increase of leukocyte count[(3.83±3.01)×109/L vs(4.36±2.97)×109/L]and serum creatinine of first day[(63.26±12.46)μmol/L vs(65.64±11.10)μmol/L]in gravity-based irrigation group was significantly higher than that in automatic irrigation pump(P=0.034,0.011,0.002,respectively).There was no significant difference between the two groups in the stone migration rate(5.3%vs 9.3%),stone residual rate(2.7%vs 4.0%),the incidence of intraoperative complications-mucosa injury of ureter(12.0%vs 10.7%),and postoperative complications(urinary tract infection:4.0%vs 5.3%,mild hydronephrosis:5.3%vs 6.7%)(P=0.347,0.649,0.797,0.868,respectively).Conclusions The automatic irrigation pump can shorten the operation time,and reduce the increase of blood routine leukocyte count and serum creatinine compared with the gravity-based irrigation.There was no difference between the
作者
邢维思
王金宁
王志强
肖荆
Xing Weisi;Wang Jinning;Wang Zhiqiang;Xiao Jing(Department of Urology,Second Affiliated Hospital of Ningxia Medical College,Yinchuan 750001,China;Department of Radiology,Second Affiliated Hospital of Ningxia Medical College,Yinchuan 750001,China;Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《国际外科学杂志》
2020年第9期609-614,共6页
International Journal of Surgery
关键词
灌注方法
输尿管镜碎石
钬激光
并发症
Irrigation method
Ureteroscopic lithotripsy
Holmium laser
Complications
