[1]贾灵华 胡美迪 熊星 包佑根 王金根.等离子柱状电极对经皮肾镜术中肾实质出血点止血效果的随机对照研究[J].中华腔镜泌尿外科杂志(电子版),2016,10(06):393-397.[doi:10.3877/cma.j.issn.1674-3253.2016.06.006 ]
 Jia Linhua,Hu Meidi,Xiong Xing,et al.Clinical efficacy of cauterization of renal parenchyma bleeding points in percutaneous nephrolithotomy with pluse cylidrical electrode: a randomized controlled trial study[J].,2016,10(06):393-397.[doi:10.3877/cma.j.issn.1674-3253.2016.06.006 ]
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等离子柱状电极对经皮肾镜术中肾实质出血点止血效果的随机对照研究()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
10
期数:
2016年06期
页码:
393-397
栏目:
临床研究
出版日期:
2016-12-31

文章信息/Info

Title:
Clinical efficacy of cauterization of renal parenchyma bleeding points in percutaneous nephrolithotomy with pluse cylidrical electrode: a randomized controlled trial study
作者:
贾灵华 1胡美迪 2熊星 1包佑根 1王金根 1
330006南昌,江西省人民医院泌尿外科 1;330006南昌大学第一附属医院老年内科 2
Author(s):
Jia Linhua1 Hu Meidi2 Xiong Xing1 Bao Yougen1 Wang Jingen1.
Department of Urology, Jiangxi Pronvincial People's Hospital, Nanchang 330006, China; 2Department of Gerontology, the Firity Affiliated Hospital of Nanchang University, Nanchang 330006, China
关键词:
肾造口术经皮出血止血随机对照研究
DOI:
10.3877/cma.j.issn.1674-3253.2016.06.006
摘要:
目的通过前瞻性随机对照研究探讨经皮肾镜术中( PCNL)使用等离子柱状电极对经皮肾通道的肾实质出血点进行电凝止血的疗效。方法 2013年 7月至 2014年 12月江西省人民医院泌尿外科因上尿路结石行 PCNL的病例中, 60例观察到肾实质明确出血点,以此 60例患者为研究对象,将其随机分为 2组,实验组 (30例)术中用等离子柱状电极对出血点电凝止血,对照组( 30例)出血点不予电凝止血,其余处理两组均按通常做法留置肾造瘘管,使用相同止血药物。术后连续 72 h收集每 24 h全部尿液,拔除肾造瘘管后再收集 24 h全部尿液,用氰化高铁血红蛋白法测定 24 h尿液中血红蛋白浓度并根据尿量计算出 24 h尿液中的血红蛋白总量,以此作为术后出血量的指标。使用两个独立样本 t检验的统计学方法分析两组出血量的差异。结果两组患者术中及术后均未出现大出血。术后第一个 24 h实验组平均丢失的血红蛋白量,明显低于对照组,差异有统计学意义([ 4.6±0.8)g vs(7.8±1.8)g,P<0.01];术后第二个 24 h实验组平均丢失的血红蛋白量明显低于对照组,差异有统计学意义([ 1.5±0.6)g vs(4.0±1.7)g,P<0.05];术后第三个 24 h实验组平均丢失的血红蛋白量略低于对照组,但差异无统计学意义[0.15(0.10)g vs 0.24(0.12)g,P>0.05];拔除肾造瘘管后 24小时实验组平均丢失的血红蛋白量明显低于对照组,差异有统计学意义([ 1.2±0.6)g vs(3.4±1.2)g,P<0.05];观察窗口期内实验组平均丢失的血红蛋白总量明显低于对照组,差异有显著的统计学意义([ 7.5±1.9)g vs(15.4± 4.3)g,P<0.01]。对照组 2例患者拔除肾造瘘管后出现一过性肉眼血尿,经保守治疗后血尿消失。结论对于 PCNL术中肾实质小出血点,术后均能自行止血,但是术中用等离子柱状电极对出血点进行电凝止血能明显减少术后出血量,尤其能明显减少术后第一天和拔除肾造瘘管后 24 h内的失血量。

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备注/Memo

备注/Memo:
基金项目:江西省卫生厅普通计划( 20155025)
通讯作者:王金根,Email:drwjg@163.com
本文编辑:阮星星 李文标) 贾灵华,胡美迪,熊星,等.等离子柱状电极对经皮肾镜术中肾实质出血点止血效果的随机对照研究[J/CD].中华腔镜泌尿外科杂志:电子版, 2016, 10(6
更新日期/Last Update: 2016-12-30