经皮肾镜术中的压力冲石与自制负压吸引清石的疗效比较

目的比较经皮肾镜碎石取石术（PCNL）中的灌注泵冲石与自制负压吸引清石的疗效。 方法回顾分析2016年3月至2017年12月采用PCNL治疗的56例肾结石患者的临床资料,均采用李逊肾镜配合气压弹道18 F经皮肾通道碎石。32例术中采用灌注泵冲出结石（传统组）。24例用"T"管自制负压吸引清石系统（改良组）。比较两组手术时间、术中出血量、并发症发生率、住院时间及结石清除率等。 结果传统组术中出血量、术后住院天数、并发症发生率及一期结石清除率与改良组比较差异无统计学意义（P>0.05）,分别为（86±10）ml vs （87±9）ml,（8.9±2.4）d vs （8.5±2.3）d,15.6%（5/32）]vs 4.2%（1/24）],84.3%（27/32）] vs 91.7%（22/24）],传统组手术时间较改良组长,为（113±5）min vs （83±5）min,差异有统计学意义（P<0.05）。 结论PCNL术中应用自制负压吸引清石法可保持术野持续清晰,有效降低肾内压,缩短手术时间,保持清石效率,值得临床推广。

Comparison of clinical efficacy between perfusion pump and self-designed negative pressure suction lithotripsy in percutaneous nephrolithotomy

ObjectiveTo compare the clinical efficacy of perfusion pump and self-designed negative pressure suction in percutaneous nephrolithotomy (PCNL) for the removal of kidney stones. MethodsClinical data of 56 patients diagnosed with kidney stones undergoing PCNL from March 2016 to December 2017 were retrospectively analyzed. All patients were treated with pneumatic ballistic 18 F PCNL under the nephroscope modified by Li Xun. Thirty-two patients received PCNL using perfusion pump (traditional group) and 24 cases were treated with PCNL with a self-made "T"-shaped negative pressure suction device for kidney stone removal (modified group). The operation time, intraoperative blood loss, the incidence of postoperative complications, the length of hospital stay and the removal rate of kidney stones were compared between the two groups. ResultsNo statistical significance was noted in terms of intraoperative blood loss (86±10) ml vs (87±9) ml], the length of hospital stay (8.9±2.4) d vs (8.5±2.3) d], the incidence of postoperative complications 15.6% (5/32) vs 4.2% (1/24)] and the stage I removal rate of kidney stones 84.3% (27/32) vs 91.7% (22/24)] between the traditional and modified group (all P>0.05), respectively. In the traditional group, the operation time was (113±5) min, significantly longer than the modified group (113±5) min vs (83±5) min, P<0.05]. ConclusionDuring PCNL, use of the self-made negative pressure suction device can maintain the surgical field clear, effectively reduce the intra-renal pressure, shorten the operation time and retain the efficiency of kidney stone removal, which is worthy of promotion and application in clinical practice.