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目的:探讨超声引导经皮肾镜取石术术中肾盂内压力的变化及与取石术后发热的关系。方法:回顾性分析96例接受经皮肾镜取石术治疗的肾结石患者临床资料,通过压力感受器实时监测术中肾盂内压力及对术后发热的影响。结果:筛选纳入的96例患者术中肾盂内压力≥30mmHg(1mmHg=0.133kPa)平均累计时间为83.17s,平均肾盂内压力为14.79mmHg。术后有26(27.1%)例患者出现发热,与感染性结石、术中平均肾盂内压力≥20mmHg、肾盂内压力≥30mmHg持续时间相关(P<0.05)。而术后发热与患者性别、年龄、尿路感染(UTI)、术后血常规白细胞≥10×109/L、术中肾盂内压力≥35mmHg无明显关系(P>0.05)。结论:经皮肾镜取石术术中平均肾盂内压力、肾盂内压力≥30mmHg持续时间与术后发热的发生率呈正相关,而肾盂内压力短暂性升高(≥35mmHg)与术后发热无明显关系。
Objective: To investigate the changes of intra-pelvic pressure in ultrasound-guided percutaneous nephrolithotomy and its relationship with fever after stone retrieval. Methods: The clinical data of 96 patients with renal calculi undergoing percutaneous nephrolithotomy were retrospectively analyzed. Intraoperative renal pelvic pressure and postoperative fever were monitored by baroreceptors in real time. Results: The average cumulative intra-renal pelvis pressure ≥30mmHg (1mmHg = 0.133kPa) was 83.17s and the average intra-pelvic pressure was 14.79mmHg in the 96 patients screened. Postoperative fever occurred in 26 (27.1%) patients and was associated with infective stones, mean intra-pelvic pressure ≥20 mmHg and intra-renal pelvic pressure ≥30 mmHg duration (P <0.05). The postoperative fever and patient gender, age, urinary tract infection (UTI), postoperative blood leukocytes ≥ 10 × 109 / L, intraoperative renal pelvis pressure ≥ 35mmHg no significant relationship (P> 0.05). Conclusions: The mean intra-renal pelvic pressure and the intra-pelvic pressure≥30mmHg in duration of percutaneous nephrolithotomy are positively correlated with the incidence of postoperative fever, while transient intrarenal pressure (≥35mmHg) and postoperative fever are not significant relationship.