论文部分内容阅读
目的探讨经皮肾镜取石术(PCNL)术后应用速即纱(Surgicel?)封闭经皮肾通道的可行性和安全有效性。方法 2012年10月至2013年10月行PCNL患者,术中取石完毕后,随机分为试验组(速即纱组)和对照组(传统PCNL组)。排除肾盂穿刺液为脓性、集合系统严重穿孔或需二期PCNL取石者后,共60例患者被纳入研究,试验组和对照组各30例,所有手术均由同一位医师完成。比较两组患者术后疼痛、Hb和HCT下降量、输血率、尿外渗及肾周血肿发生率、住院时间等。结果两组患者年龄、性别、结石大小、肾积水程度、术前Hb和HCT差异均无统计学意义。试验组术后平均住院时间3.23 d,对照组7.02 d,术后疼痛视觉模拟评分(VAS)试验组为2.36,对照组为5.12,两组差异均有统计学意义(P<0.01);两组术后Hb和HCT下降量、手术时间、结石清除率及发热发生率差异无统计学意义(P>0.05)。两组无肾周血肿、尿漏发生,无需输血病例。结论 PCNL术后应用速即纱封闭经皮肾通道安全、有效、可行,可预防通道出血和尿外渗,有助于拓展无管化PCNL的应用范围。
Objective To investigate the feasibility and safety of percutaneous nephrolithotomy (PCNL) for the closure of percutaneous renal channels with Surgicel ?. Methods From October 2012 to October 2013, patients with PCNL were randomly divided into test group (fast yarn group) and control group (conventional PCNL group) after operation. A total of 60 patients were enrolled in the study, 30 in the trial group and 30 in the control group, all of whom were performed by the same physician, excluding patients with purulent peritoneal puncture fluid, severe perforation of the collection system or PCNL stage II. Postoperative pain, Hb and HCT decline, blood transfusion rate, urinary extravasation and perihematomal hematoma incidence and hospital stay were compared between the two groups. Results There was no significant difference in age, sex, size of stone, degree of hydronephrosis, preoperative Hb and HCT between the two groups. The average postoperative hospital stay was 3.23 days in the experimental group, 7.02 days in the control group, 2.36 in the VAS test group and 5.12 in the control group, respectively (P <0.01) The postoperative Hb and HCT decreased amount, operation time, stone removal rate and fever incidence difference was not statistically significant (P> 0.05). No renal hematoma in both groups, urine leakage occurred, without transfusion cases. Conclusion PCNL is a safe, effective and feasible method for the closure of percutaneous renal channels after operation, which can prevent channel bleeding and urinary extravasation and help to expand the application range of PCNL.