使用负压清石鞘对经皮肾镜碎石术术后感染相关并发症的影响

目的探讨使用负压清石鞘是否可以降低经皮肾镜碎石术术后感染相关并发症发生率。方法回顾性分析2018年7月至2019年8月在华中科技大学同济医院行单通道(F20)经皮肾镜碎石术的226例患者资料。根据术中是否使用负压清石鞘分为负压组(n=85)及对照组(n=141)。所有手术均采用超声引导下穿刺,建立F20经皮肾通道。统计所有患者基本资料、手术相关参数、术后感染相关并发症发生率等数据。结果所有患者均顺利完成手术。负压组患者年龄大于对照组(55.00±10.01)vs.(51.95±12.83)岁,P=0.138]。负压组与对照组患者性别比、BMI、术前尿培养阳性史比例、结石大小、手术时间等均无统计学差异。负压组术后全身系统炎症综合征(SIRS)或脓毒血症(sepsis)的发生率低于对照组(2.35%vs.9.93%,P=0.031),且负压组患者术后住院时间更短(5.035±1.742)vs.(5.823±2.370)d,P=0.004]。结论采用负压清石鞘可以降低经皮肾镜碎石术术后感染相关并发症发生率,促进患者恢复。

Effects of ClearPetra access sheath with vacuum suction on infection-related complications following percutaneous nephrolithotomy

Objective To explore whether ClearPetra access sheath with vacuum suction can reduce the incidence of infection-related complications following percutaneous nephrolithotomy(PCNL).Methods Clinical data of 226 patients who received single-channel(F20)PCNL in Tongji Hospital during Jul.2018 and Aug.2019 were retrospectively analyzed.Based on whether or not ClearPetra access sheath was used during operation,the patients were divided into ClearPetra group(n=85)and control group(n=141).All procedures were performed under ultrasound guided puncture to establish a F20 percutaneous renal access.Baseline data of patients,operation-related parameters and postoperative infection-related complications were compared between the two groups.Results All operations were successfully performed.Patients in the ClearPetra group were older than those in the control group(55.00±10.01)vs.(51.95±12.83)years,P=0.138].There were no significant differences in gender ratio,body mass index(BMI),preoperative urine culture positive history ratio,stone size and operation time between the two groups.The ClearPetra group had lower incidences of systemic inflammatory response syndrome(SIRS)or sepsis(2.35%vs.9.93%,P=0.031),and shorter postoperative hospital stay(5.035±1.742)vs.(5.823±2.370)days,P=0.0046]than the control group.Conclusion ClearPetra access sheath with vacuum suction can reduce incidence of infection-related complications after PCNL and promote patients recovery.