PCNL肾造瘘管留置对患者术后出血、炎症反应情况的影响研究
Effect of indentation of PCNL nephrostomy tube on postoperative bleeding and inflammation
徐启鹏 1章钟 1凌峰 1张国华 1王刚 1周先明2
作者信息
- 1. 242300 宣城,宁国市人民医院泌尿外科
- 2. 池州市人民医院泌尿外科
- 折叠
摘要
目的 研究经皮肾镜碎石取石术(PCNL)肾造瘘管留置对患者术后出血、炎症反应情况的影响.方法 回顾性分析 2017 年 12 月～2021 年 12 月在宁国市人民医院行PCNL的肾结石患者 100 例,根据患者有无留置肾造瘘管划分为对照组、观察组,各50 例,对照组留置肾造瘘管,观察组未留置肾造瘘管.对比两组患者结石清除率、手术时间和住院时间,同时对比两组患者的术后出血情况、术前及术后 1 d炎性因子水平变化情况.结果 两组患者结石清除率、手术时间比较,差异无统计学意义(P>0.05);对照组住院时间长于观察组[(15.28±4.82)d vs.(11.68±4.56)d],差异有统计学意义(t=3.836,P<0.05);对照组和观察组术后出血发生率(8.00%vs.6.00%)、术后出血量[(221.47±42.58)ml vs.(215.68±39.74)ml]对比差异无统计学意义(t=0.703,P>0.05);术后 1 d,两组患者的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)水平均高于术前,且对照组术后 1 d的CRP、TNF-α、IL-6 水平分别为(23.17±3.74)mg/L、(11.93±2.27)pg/L、(21.85±3.72)pg/L,明显高于观察组(20.85±3.6)mg/L、(10.75±2.11)pg/L、(19.68±3.55)pg/L,差异均有统计学意义(t=3.122、2.692、2.984,P<0.05).结论 在PCNL中留置或不留置肾造瘘管均能获得良好的结石清除率,但留置肾造瘘管会延长住院时间,加剧患者术后炎症反应,恢复进程较慢.
Abstract
Objective To investigate the effects of percutaneous nephrolithotripsy(PCNL)onpostoperative bleeding and inflammation.Methods A retrospective analysis was performed on the clinical data of 100 patients with renal calculus who received PCNL in our hospital from December 2017 to December 2021.The patients were divided into 2 groups according to whether the patients had indwelling nephrostomy tubes,with 50 cases in each group.The control group had indwelling nephrostomy tubes,while the study group did not.Calculus clearance rate,operation time and hospital stay were compared between the two groups.Meanwhile,postoperative bleeding,changes in inflammatory factors before and on the 1st day after surgery were compared between the two groups.Results The stone clearance rate and operation time of the control group and the study group were similar,and the difference was not statistically significant(P>0.05),while the hospital stay of the control group was longer than that of the study group(P<0.05).There was no significant difference in the incidence of postoperative bleeding(8.00%vs.6.00%)and the amount of postoperative bleeding[(221.47±42.58)ml vs.(215.68±39.74)]ml between the control group and the study group(P>0.05).On the first day after surgery,the levels of C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in both groups were higher than those before surgery.The levels of CRP,TNF-α and IL-6 in the control group were(23.17±3.74)mg/L,(11.93±2.27)pg/L and(21.85±3.72)pg/L,respectively.It was significantly higher than that of the study group(20.85±3.6)mg/L,(10.75±2.11)pg/L,(19.68±3.55)pg/L(P<0.05).Conclusion In PCNL patients with or without renal fistulas,good stone removal rate can be achieved.But the renal fistulas may prolong the hospital stay,aggravate the postoperative inflammatory reaction and slow the recovery process down.
关键词
肾结石/经皮肾镜碎石取石术/肾造瘘管留置/术后出血/炎症反应Key words
Kidney stone/Percutaneous nephrolithotripsy/Nephrostomy catheter indwelling/Postoperative hemorrhage/Inflammatory response引用本文复制引用
基金项目
安徽省卫生健康委科研项目(AHWJ20216131)
出版年
2024
NETL
NSTL
万方数据