熊流水 黄明

[摘要]目的 探讨选择性肾周引流管代替肾造瘘管在微创经皮肾镜术后的应用效果。方法 选取江西省石城县中医院2012年1～12月收治的22例行经皮肾镜术的患者作为研究对象，根据引流方式分为对照组和观察组，每组11例。对照组采用肾造瘘管，观察组采用肾周引流管。比较两组患者的并发症发生率、继发出血量、住院时间和医疗费用。结果 观察组的并发症总发生率为18.2%，显著低于对照组的45.5%，差异有统计学意义（P<0.05）。观察组的继发出血量明显少于对照组、住院时间明显短于对照组、医疗费用明显低于对照组，差异均有统计学意义（P<0.05）。结论 与肾造瘘管比较，选择性肾周引流管的安全性高，临床效果好，可减少继发出血量、缩短住院时间和降低医疗费用。

[关键词]选择性肾周引流管；肾造瘘管；微创经皮肾镜术

[中图分类号] R691.4 [文献标识码] A [文章编号] 1674-4721（2018）9（a）-0097-03

[Abstract] Objective To explore the application effect of selective perirenal drainage tube instead of nephrostomy tube after minimally invasive percutaneous nephrolithotomy. Methods A total of 22 patients with percutaneous nephrolithotomy treated in Shicheng Traditional Chinese Medicine Hospital from January to December 2012 were selected as study objects， and they were divided into the control group and observation group according to drainage ways， and there were 11 cases in each group. The control group was treated with nephrostomy tube， while the observation group was treated with perirenal drainage tube. The incidence of complications， secondary bleeding volume， hospital stay and medical expenses were compared in patients between the two groups. Results The total incidence of complications in the observation group was 18.2%， which was significantly lower than that of the control group （45.5%）， and the difference was statistically significant （P<0.05）. The secondary bleeding volume in the observation group was significantly fewer those that of the control group， the hospital stay was significantly shorter than the control group and the medical expenses were significantly lower than those of the control group， and the differences were statistically significant （P<0.05）. Conclusion Compared with the nephrostomy tube， selective perinephric drainage tube has higher safety and better clinical effect， and it can reduce secondary blood flow， shorten the hospital stay and reduce medical expenses.

[Key words] Selective perirenal drainage tube； Nephrostomy tube； Minimally invasive percutaneous nephrolithotomy

微创经皮肾镜钬激光碎石术是现阶段治疗尿路结石的重要医疗方式，与传统治疗手段比较，它具有创伤小、见效快、安全性高等优势[1]。肾造瘘管有利于观察肾脏出血情况，缓解尿路梗阻，引导血液、脓液和尿液流出，促进窦道形成，改善肾功能，为症状严重者行再次手术做好准备工作[2]。但应用期间可能出现造瘘管堵塞、脱落感染和尿液外渗等并发症，影响引流效果[3]。江西省石城县中医院采用选择性肾周引流管代替肾造瘘管在微创经皮肾镜术后护理工作中取得了明显效果，现报道如下。

1资料与方法

1.1一般资料

选取我院2012年1～12月收治的22例行微创经皮肾镜术患者作为研究对象，根据引流方式分为对照组和观察组，每组11例，两组患者均术中放置输尿管双J管。对照组男6例，女5例；年龄36～78岁，平均（56.2±1.5）岁；病程1.2～13.5年，平均（7.8±0.6）年。观察组男5例，女6例；年龄38～79岁，平均（56.7±0.5）岁；……