低压冲洗经皮肾镜超声碎石清石术48例

Percutaneous nephroscope ultrasonic lithotripsy of 48 patients with low pressure flush

摘要:

目的 探讨低压冲洗经皮肾镜超声碎石清石安全性与可行性。方法 48例肾和输尿管上段结石患者采用经皮肾镜标准通道（24 F）超声碎石清石治疗。术中均采取袋装生理盐水冲洗，灌注压保持在30～50 cmH2O，并测量最大肾盂压。结果 术中最大肾盂压为23 cmH2O。术野显露清晰，术后3例发热，T为38.5℃，其余患者T<38.5℃，无尿脓毒症发生。术后2~4周CT、B超或X线平片复查，结石清除率为95.83%（46/48）。结论 在经皮肾镜超声碎石术中采取标准通道和袋装生理盐水低压冲洗安全可行，可减少术后尿脓毒症发生，有较好的临床推广应用价值。

Abstract:

【Objective】 To discuss the safety and feasibility of the low pressure flush percutaneous nephroscope ultrasonic lithotripsy . 【Methods】 48 cases of renal and ureteral calculi were treated by percutaneous nephrolithotomy (24 F) standard channel stone treatment ultrasound lithotripsy. All patients were flushed with the bag of physiological saline, perfusion pressure was maintained at 30~50 cmH2O, and the maximum of renal pelvic pressure was measured.【Results】 Intraoperative maximum renal pelvic pressure was 23 cmH2O. The operative field is clear, 3 cases of postoperative fever, T was 38.5℃, the remaining patients with T<38.5℃, no urinary sepsis. After 2 to 4 weeks CT, B ultrasound or X-ray examination, the stone free rate was 95.83% (46/48). 【Conclusion】 Percutaneous nephroscope ultrasonic lithotripsy taking standard channel and saline low pressure flush is safe and feasible, which has a good clinical application value.