微创经皮肾镜取石术后气囊导尿管作肾造瘘管的优势

目的：评估双腔气囊导尿管在微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy，mPCNL) 后作肾造瘘管的优势。方法：前瞻性收集2015年10月至2016年4月明确诊断为上尿路结石且应用mPCNL治疗的137例 患者的临床资料，随机将病例资料分为气囊导尿管组(实验组，n=69)与普通造瘘管组(对照组，n=68)。对照研究两组 术后出血量、出血天数、管道脱落情况、疼痛程度，并总结mPCNL术后肾造瘘管的护理经验。结果：实验组术后出 血量、出血天数明显低于对照组，差异均有统计学意义(均P<0.01)。实验组术后脱管率较对照组明显降低，差异有统 计学意义(P<0.05)。两组术后疼痛评分差异无统计学意义(P>0.05)，实验组患者并未由于放置气囊导尿管而出现其他 并发症和不适症状。结论：上尿路结石行mPCNL后，留置双腔气囊导尿管替代普通肾造瘘管是安全的，能有效减少 术后出血，并且可降低术后脱管率，不增加患者术后疼痛，可降低术后护理难度及风险。

Advantages of foley catheter for nephrostomy tube after minimally invasive percutaneous nephrolithotomy

Objective: To assess the advantages and nursing experience of foley catheter for nephrostomy tube aft er minimally invasive percutaneous nephrolithotomy (mPCNL). Methods: From October 2015 to April 2016, the clinical data of 137 patients, who were diagnosed with upper urinary tract calculi and need to perform mPCNL, were collected and randomized into 2 groups: a foley catheter group (research group, n=69) and a normal nephrostomy tube group (control group, n=68). Th e patients in research group used foley catheter for nephrostomy tube, while those in the control group used normal nephrostomy tube. Bleeding volume, the days of bleeding, pipes shedding and pain degree were compared, and the experience of the nursing process was summarized. Results: The bleeding volume, the days of bleeding in the research group were significantly lower than those in the control group (both P<0.01). The pipes shedding rate in the research group were lower than that in the control group (P<0.05). There was no significant difference in postoperative pain scores between the 2 groups (P>0.05). There was no other complications and discomfortable symptoms in the experimental group. Conclusion: The use of foley catheter for nephrostomy tube after mPCNL is safe, and it can decrease the bleeding volume and pipes shedding rate. It doesn’t increase the patient's postoperative pain and can reduce the difficulty and risk for postoperative nursing.