本文選題：腎結(jié)石 + 經(jīng)皮腎鏡取石術(shù)�。� 參考：《中華醫(yī)院感染學(xué)雜志》2016年19期

【摘要】：目的研究經(jīng)皮腎鏡取石術(shù)中不同灌注壓力對于術(shù)后患者感染狀態(tài)及腎功能的影響,為臨床上灌注壓力的選擇提供依據(jù)。方法回顧性分析2014年10月-2015年10月在醫(yī)院行經(jīng)皮腎鏡取石術(shù)70例患者臨床資料,其中高灌注壓力組患者33例,低灌注壓力組患者37例,比較兩組患者手術(shù)前后生命體征、休克指數(shù)、血白細胞計數(shù)、中性粒細胞百分率、血肌酐濃度等的差異。結(jié)果高灌注壓力組患者術(shù)后24、48、72h的體溫、中性粒細胞百分率、血肌酐濃度均高于低灌注壓力組,差異有統(tǒng)計學(xué)意義(P0.05);高灌注壓力組患者術(shù)后24、48h休克指數(shù)高于低灌注壓力組,差異有統(tǒng)計學(xué)意義(P0.05),而術(shù)后72h兩組患者休克指數(shù)差異無統(tǒng)計學(xué)意義;兩組患者術(shù)后24、48、72h脈率、收縮壓、血白細胞計數(shù)差異均無統(tǒng)計學(xué)意義。結(jié)論高灌注壓力組患者術(shù)后體溫、中性粒細胞百分率、血肌酐濃度、休克指數(shù)均高于低灌注壓力組,即高灌注壓力組患者術(shù)后感染狀態(tài)更加嚴重,腎功能損害也相對嚴重,而術(shù)后72h兩組患者的休克指數(shù)相比差異無統(tǒng)計學(xué)意義,這說明隨著術(shù)后補液、抗感染等治療措施的實施,患者感染減輕,逐漸好轉(zhuǎn)。
[Abstract]:Objective to study the effect of different perfusion pressure on the infection status and renal function during percutaneous nephrolithotomy, and to provide evidence for clinical selection of perfusion pressure. Methods the clinical data of 70 patients undergoing percutaneous nephrolithotomy from October 2014 to October 2015 were analyzed retrospectively, including 33 patients in high perfusion pressure group and 37 patients in low perfusion pressure group. The vital signs before and after operation were compared between the two groups. Shock index, white blood cell count, neutrophil percentage, serum creatinine concentration, etc. Results the body temperature, percentage of neutrophils and serum creatinine concentration in the high perfusion pressure group were significantly higher than those in the low perfusion pressure group at 24: 48 h, and the shock index was higher in the high perfusion pressure group than in the low perfusion pressure group at 2448 hours after operation. There was no significant difference in shock index between the two groups at 72 hours after operation, but there was no significant difference in pulse rate, systolic blood pressure and white blood cell count between the two groups at 24: 48 and 72 hours after operation. Conclusion the postoperative body temperature, percentage of neutrophils, serum creatinine concentration and shock index in the high perfusion pressure group were higher than those in the low perfusion pressure group, that is, the postoperative infection status and renal function damage were more serious in the high perfusion pressure group than in the low perfusion pressure group. However, there was no significant difference in shock index between the two groups at 72 hours after operation, which indicated that with the implementation of post-operative rehydration, anti-infection and other treatment measures, the infection of the patients decreased and gradually improved.
【作者單位】： 中山大學(xué)附屬第三醫(yī)院生殖醫(yī)學(xué)中心;中山大學(xué)附屬第三醫(yī)院嶺南醫(yī)院泌尿外科;
【基金】：廣東省自然科學(xué)基金資助項目(S2013040014333)
【分類號】：R699.2
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本文編號：1844332