微通道和标准通道经皮肾镜碎石术对肾结石患者血流动力学和血气分析的影响

doi:10.3969/j.issn.1006-6233.2019.06.002

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摘要目的: 分析微通道和标准通道经皮肾镜碎石术对肾结石患者血流动力学和血气分析的影响。方法: 选取本院2016年1月至2018年6月80例肾结石患者,均行经皮肾镜碎石术,分为A组采取微通道,B组采取标准通道,两组各40例。比较两组患者灌流液量、手术时间及不同时间点血流动力学和动脉血气分析指标的差异。结果: B组灌流液量较A组明显减少,手术时间较A组明显缩短(P<0.01)。两组患者在不同时间点时心率(HR)的组内比较,并无明显差异(P>0.05);两组灌流前(T2)中心静脉压(CVP)及平均动脉压(MAP)较麻醉前(T1)均明显减少(P<0.05),灌流10min(T3)与灌流前(T2)CVP及MAP的比较,并无明显差异(P>0.05);灌流30min(T4)、灌流60min(T5)及术后(T6)CVP及MAP较T2均明显增高(P<0.05);两组患者在不同时间点时HR、CVP及MAP的组间比较,并无明显差异(P>0.05)。两组术后(t3)剩余碱(BE)、pH、K⁺较麻醉前(t1)均明显下降(P<0.05);在不同时间点时,两组患者pH、K⁺、BE的组间比较,并无明显差异(P>0.05)。两组患者并发症发生率的比较,并无明显差异(P>0.05)。结论: 行经皮肾镜碎石术治疗的肾结石患者灌流液的吸收随着手术时间的增加,其对动脉血气分析及血流动力学的影响亦逐渐明显;因器官功能的代偿,标准通道与微通道经皮肾镜碎石术导致灌流液吸收量的不同,并不会引起患者动脉血气分析及血流动力学的明显差异。

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关键词 ：肾结石, 经皮肾镜碎石术, 标准通道, 微通道, 血流动力学

Abstract：Objective: To analyze the effects of microchannel and standard channel percutaneous nephrolithotomy on hemodynamics and blood gas analysis in patients with renal calculus. Methods: 80 cases of renal calculus in our hospital from January 2016 to June 2018 were treated by percutaneous nephrolithotomy. They were divided into group A with microchannel and group B with standard channel, with 40 cases in each group. The perfusion volume, operation time, hemodynamics and arterial blood gas analysis indexes were compared between the two groups. Results: The perfusion volume in group B was significantly lower than that in group A, and the operative time was significantly shorter than that in group A (P<0.01). There was no significant difference in heart rate (HR) between the two groups at different time points (P> 0.05); central venous pressure (CVP) and mean arterial pressure (MAP) before perfusion (T2) were significantly lower than those before anesthesia (T1) (P< 0.05), and there was no significant difference in CVP and MAP between perfusion 10 minutes (T3) and pre-perfusion (T2) (P> 0.05); 30 minafter perfusion (T4), 60 minafter perfusion (T5) and postoperative (T6) CVP and MAP were significantly higher than those of T2 (P< 0.05); HR, CVP and MAP were not significantly different between the two groups at different time points (P> 0.05). The base excess (BE), pH and K⁺ of the two groupsafter operation (t3) were significantly lower than those before anesthesia (t1) (P<0.05); there was no significant difference in pH, K⁺, BE between the two groups at different time points (P> 0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: With the increase of operation time, the absorption of perfusate in patients with renal calculus treated by percutaneous nephrolithotomy has obvious influence on arterial blood gas analysis and hemodynamics, and because of the compensation of organ function, the difference of perfusion fluid absorption between standard channel and microchannel percutaneous nephrolithotomy does not cause significant difference in arterial blood gas analysis and hemodynamics.

Key words： Renal calculus Percutaneous nephrolithotomy Standard channel Microchannel Hemodynamics

基金资助:安徽省自然科学基金项目,(编号:1608085MH134)

通讯作者: 吴齐

引用本文:

焦常宝, 吴齐, 徐兵, 仰光, 王正跃. 微通道和标准通道经皮肾镜碎石术对肾结石患者血流动力学和血气分析的影响[J]. 河北医学, 2019, 25(6): 886-889.
JIAO Changbao, WU Qi, XU Bing. Effects of Microchannel and Standard Channel Percutaneous Nephrolithotomy on Hemodynamics and Blood Gas Analysis in Patients with Renal Calculus. HeBei Med, 2019, 25(6): 886-889.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.06.002 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I6/886

[1] 陈晨,王臣,李子良,等.组合式输尿管软镜联合钬激光碎石术与经皮肾镜碎石术治疗肾结石对比研究[J].河北医学,2018,24(8):1358~1362.
[2] Wang YB, Cui YX, Song JN, et al.Efficacies of various surgical regimens in the treatment of renal calculi patients: a network meta-analysis in 25 enrolled controlled clinical trials[J].Kidney Blood Press Res,2018,43(4):1183~1198.
[3] Gupta S, Das SK, Pal DK.Total tubeless ultra-mini supine percutaneous nephrolithotomy: A feasibility study[J].Turk Urol,2018,44(4):323~328.
[4] Tailly T, Denstedt J.Innovations in percutaneous nephrolithotomy[J].Int Surg,2016,36(Pt D):665~672.
[5] Batagello CA, Vicentini FC, Marchini GS, et al.Current trends of percutaneous nephrolithotomy in a developing country[J].Int Braz Urol,2018,44(2):304~313.
[6] Shi X, Peng Y, Li L, et al.Renal function changes after percutaneous nephrolithotomy in patients with renal calculi with a solitary kidney compared to bilateral kidneys[J].BJU Int,2018,122(4):633~638.
[7] Ozgor F, Yanaral F, Savun M, et al.Comparison of miniaturized percutaneous nephrolithotomy and flexible ureterorenoscopy for moderate size renal stones in elderly patients[J].Kaohsiung Med Sci,2018,34(6):352~356.
[8] Ghani KR, Andonian S, Bultitude M, et al. Percutaneous nephrolithotomy: Update, trends, and future directions[J].Eur Urol,2016,70(2):382~396.
[9] Budak S, Yucel C, Kisa E, et al.Comparison of two different renal access techniques in one-stage percutaneous nephrolithotomy: triangulation versus eye of the needle[J].Ann Saudi Med,2018,38(3):189~193.
[10] 疏翀,项平,朱劲松,等.微通道和标准通道经皮肾镜碎石术治疗上尿路结石的疗效及对机体应激状态的影响[J].广西医科大学学报,2017,34(11):1614~1617.
[11] Sarikaya S, Unsal A, Ebiloglu T, et al.Is retrograde intrarenal surgery replacing percutaneous nephrolithotomy as surgical treatment of stone disease: Our clinical experience[J].Arch Esp Urol,2018,71(5):506~511.