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目的探讨温生理盐水非灌注泵低压冲洗经皮肾镜取石术(PCNL)治疗老年肾结石的安全性及疗效。方法对63例老年(≥65岁)肾结石患者采用PCNL治疗,术中采取温热(37~38℃)袋装生理盐水非灌注泵低压冲洗,压力保持在30~50cmH2O,并测量最大肾盂压。结果 63例患者成功建立皮肾单通道,一期碎石49例,二期碎石14例;结石总清除率84.1%(53/63),术后发热2例(>38.5℃),无低体温、凝血功能异常、气胸、胸腹腔积液、腹腔脏器损伤、尿源性脓毒血症、心肺功能衰竭等并发症。51例肾积水患者,积水消失或明显改善45例,无变化6例。8例肾功能不全患者,肾功能正常或明显改善者6例,无变化2例。结论 PCNL术中采取温生理盐水非灌注泵低压冲洗安全可靠,操作简便,可降低发热、出血及尿源性脓毒血症。
Objective To investigate the safety and efficacy of warm saline saline non-perfusion pump in percutaneous nephrolithotomy (PCNL) in the treatment of senile renal calculi. Methods Sixty-three elderly patients (≥65 years old) with renal calculi were treated with PCNL. The patients were treated with warm (37-38 ℃) bagged saline non-perfusion pump under low pressure during operation. The pressure was maintained at 30-50cmH2O and the maximum renal pelvis pressure . Results Sixty-three patients were successfully established with single-pass nephritis, 49 cases of primary gravel, and 14 cases of secondary gravel. The total removal rate of stone was 84.1% (53/63), postoperative fever was 2 (> 38.5 ℃) Body temperature, coagulation dysfunction, pneumothorax, pleural effusion, abdominal organ damage, urinary sepsis, cardiopulmonary failure and other complications. 51 cases of hydronephrosis, hydronephrosis disappeared or significantly improved in 45 cases, no change in 6 cases. 8 patients with renal insufficiency, renal function was normal or significantly improved in 6 cases, no change in 2 cases. Conclusions PCNL intraoperative use of warm saline non-perfusion pump low pressure flush safe and reliable, easy to operate, can reduce fever, hemorrhage and urinary sepsis.