在完全无管经皮肾镜取石术后使用速即纱封闭肾造瘘通道。
Use of Surgicel for sealing nephrostomy tract after totally tubeless percutaneous nephrolithotomy.
作者信息
Aghamir S M K, Khazaeli M H, Meisami A
机构信息
Department of Urology, Sina Hospital, Tehran, Iran.
出版信息
J Endourol. 2006 May;20(5):293-5. doi: 10.1089/end.2006.20.293.
BACKGROUND AND PURPOSE
Fibrin glue and gelatin matrix have been used to seal nephrostomy tracts to reduce bleeding and extravasation after tubeless percutaneous nephrolithotomy (PCNL). In this study, Surgicel (oxidized cellulose) was used to seal the nephrostomy tract after totally tubeless PNL.
PATIENTS AND METHODS
Twenty patients with kidney calculi were treated with totally tubeless PNL. According to randomization, at the conclusion of surgery, the nephrostomy tracts were sealed with Surgicel in ten patients and left unsealed in the other ten. Postoperatively, the two groups were compared with respect to hematocrit changes and extravasation as detected by abdominal ultrasonography and wound-dressing inspection.
RESULTS
There was statistically significant decrease in the hematocrit in both the study (P = 0.017) and the control (P = 0.003) group. When the two groups were compared with respect to the decrease in hematocrit, no statistically significant difference was seen (P = 0.241). Similarly, extravasation from the nephrostomy tract was not significantly different in the two groups.
CONCLUSION
Sealing the nephrostomy tract with Surgicel after totally tubeless PNL did not decrease bleeding or extravasation from the tract.
背景与目的
纤维蛋白胶和明胶基质已被用于封闭肾造瘘通道，以减少无管经皮肾镜取石术（PCNL）后的出血和渗漏。在本研究中，速即纱（氧化纤维素）被用于完全无管PCNL术后封闭肾造瘘通道。
患者与方法
20例肾结石患者接受了完全无管PCNL治疗。根据随机分组，手术结束时，10例患者的肾造瘘通道用速即纱封闭，另外10例不封闭。术后，比较两组患者的血细胞比容变化以及通过腹部超声检查和伤口敷料检查发现的渗漏情况。
结果
研究组（P = 0.017）和对照组（P = 0.003）的血细胞比容均有统计学意义的下降。当比较两组血细胞比容的下降情况时，未发现统计学意义的差异（P = 0.241）。同样，两组肾造瘘通道的渗漏情况也无显著差异。
结论
完全无管PCNL术后用速即纱封闭肾造瘘通道并不能减少通道出血或渗漏。
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