CAJ | 학술논문

目的探讨微通道经皮肾镜取石术(MPCNL)并发腹腔积液的相关临床原因及其预防措施.方法回顾性分析285例MPCNL治疗的上尿路结石患者的临床资料,按有无腹腔积液分为腹腔积液组和无腹腔积液组,分析并发腹腔积液的原因.结果手术均获成功.腹腔积液组21例,无腹腔积液组264例.单因素分析结果显示腹腔积液的发生与结石直径和数目、灌注压力、灌洗时间、灌洗液用量、术前上尿路感染、上尿路结石治疗史相关(P＜0.05),而与年龄、性别、体质量指数无相关性(P＞0.05).多因素Logistic回归分析显示灌注压力、灌洗时间和灌洗液用量是MPCNL后并发腹腔积液的独立危险因素(P＜0.05).结论 MPCNL并发腹腔积液,与术中灌洗液用量大、灌洗时间长和术中灌注压力高等因素密切相关;在保持手术视野清晰的前提下尽可能降低灌注压力,控制灌洗液的流速,减少灌洗液用量,可以降低腹腔积液的发生率.
목적 탐토미통도경피신경취석술(MPCNL)병발복강적액적상관림상원인급기예방조시.방법 회고성분석285례MPCNL치료적상뇨로결석환자적림상자료,안유무복강적액분위복강적액조화무복강적액조,분석병발복강적액적원인.결과 수술균획성공.복강적액조21례,무복강적액조264례.단인소분석결과현시복강적액적발생여결석직경화수목、관주압력、관세시간、관세액용량、술전상뇨로감염、상뇨로결석치료사상관(P＜0.05),이여년령、성별、체질량지수무상관성(P＞0.05).다인소Logistic회귀분석현시관주압력、관세시간화관세액용량시MPCNL후병발복강적액적독립위험인소(P＜0.05).결론 MPCNL병발복강적액,여술중관세액용량대、관세시간장화술중관주압력고등인소밀절상관;재보지수술시야청석적전제하진가능강저관주압력,공제관세액적류속,감소관세액용량,가이강저복강적액적발생솔.
Objective To explore the clinical causes and preventive measures of complicating ascites of mini-percutaneous nephrolithotripsy (MPCNL).Methods Retrospective analysis of 285 patients with MPCNL for upper urinary tract calculus,which were divided into ascites group and no-ascites group.Results All the procedures were successful.Ascites group of 21 cases,no-ascites group of 264 cases.Univariate analysis showed that the diameter and number of calculus,perfusion pressure,perfusion time,pressure volume of irrigation fluid,preoperative upper urinary tract infection,history of treatment associated with complicating ascites (P＜ 0.05),with age,gender,body mass index no correlation (P＞ 0.05).Logistic regression analysis showed that perfusion pressure,perfusion time,pressure volume of irrigation fluid was independent risk factors after MPCNL concurrent ascites (P ＜ 0.05).Conclusions MPCNL concurrent ascites are closely related to the large perfusion volume,the long operative perfusion time,the high perfusion pressure of irrigation fluid.On the premise of keeping the operative visual field clear,as far as possible to reduce the perfusion pressure,control irrigation fluid-flow rate,reduce the large peffusion volume.These could decrease the coincidence of the ascites.