Yang Zhongsheng, Song Leming, Xie Donghua, Deng Xiaolin, Zhu Lunfeng, Fan Difu, Peng Zuofeng, Guo Shulin, Ye Zhangqun
Department of Urology, The Affiliated Ganzhou Hospital of Nanchang University, Ganzhou, Jiangxi, China.
Urol Int. 2016;97(1):61-6. doi: 10.1159/000442002. Epub 2016 Jan 20.
In order to better control renal pelvic pressure (RPP), reduce surgical complications and increase operative efficacy of minimally invasive percutaneous nephrolithotomy (MPCNL), we designed an MPCNL with intelligent monitoring and control of RPP and sought to explore its clinical efficacy and characteristics.
This study included 60 patients with renal staghorn calculi. A 5F ureteral catheter was connected to an invasive blood pressure monitor for monitoring and control of RPP. A 12F renoscope was inserted through a percutaneous tract for lithotripsy using a laser, with the help of an intelligent system to monitor RPP continuously, which includes an irrigation and suctioning platform and an integrated intraluminal pressure sensory PCNL suctioning sheath. Before the lithotripsy, intraluminal pressure control value and perfusion flow were set on the platform.
RPP was maintained at a range of -12 to 2 mm Hg. The mean operative time was 120 min. The mean intraoperative bleeding amount was 100 ml. Fifty-two of the 60 patients the stones were cleared by one surgery.
In our suctioning MPCNL with the intelligent control of RPP, the intraoperative RPP could be accurately controlled within the preset safety range. The stone clearance rate was high.
为了更好地控制肾盂压力(RPP),减少手术并发症并提高微创经皮肾镜取石术(MPCNL)的手术疗效,我们设计了一种具有RPP智能监测与控制功能的MPCNL,并探讨其临床疗效和特点。
本研究纳入60例鹿角形肾结石患者。将一根5F输尿管导管连接到有创血压监测仪上,用于监测和控制RPP。通过经皮通道插入一根12F肾镜,借助智能系统持续监测RPP,使用激光进行碎石,该智能系统包括一个冲洗吸引平台和一个集成腔内压力传感PCNL吸引鞘。在碎石术前,在平台上设置腔内压力控制值和灌注流量。
RPP维持在-12至2 mmHg范围内。平均手术时间为120分钟。术中平均出血量为100毫升。60例患者中有52例一次手术结石清除。
在我们具有RPP智能控制功能的吸引式MPCNL中,术中RPP可精确控制在预设的安全范围内。结石清除率高。