Application of percutaneous nephrolithotomy with ClearPetra negative pressure sheath in the treatment of obstructive calculous pyonephrosis

doi:10.3877/cma.j.issn.1674-3253.2019.01.004

Abstract

Abstract:

Objective

To investigate the clinical value of percutaneous nephrolithotomy (PCNL) combined with ClearPetra negative pressure sheath in the treatment of obstructive calculous pyonephrosis.

Methods

From March to December 2016, 76 patients underwent PCNL in the Fifth Affiliated Hospital were randomly divided into two groups, 38 cases in each group. Patients in group A were treated with CREATE combined with Cyberwand double probe ultrasound lithotripsy, and group B were treated with ClearPetra negative pressure stone sheath combined with pneumatic lithotripsy and/or holmium laser lithotripsy.

Results

All patients were treated with Ⅰ stage operation successfully. Compared with group A, group B had a higher rate of stone removal (84.2% vs 63.1%, P=0.037). There was no significant difference in stone clearance (94.4% vs 86.8%, P=0.43). The operation time of group B, significantly shorter than that of group A at [(56±20) min vs (70±15) min, P=0.035]. The complication rate of group B was lower than that of group A (15.8% vs 23.7%, P=0.035).

Conclusion

PCNL combined with ClearPetra negativepressure clear stone sheath is a simple, safe and effective, economical and practical method for the treatment of obstructive calculous pyonephrosis.

Key words: PCNL, Negative pressure sheath, Obstructive, Calculous pyonephrosis, Randomly

Dehui Lai, Ming Sheng, Mingzhao Li, Xun Li, Yongzhong He, Tian Li, Guibin Xu, Weiqing Yang. Application of percutaneous nephrolithotomy with ClearPetra negative pressure sheath in the treatment of obstructive calculous pyonephrosis[J]. Chinese Journal of Endourology(Electronic Edition), 2019, 13(01): 15-19.

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References 15

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组别	例数	年龄（岁， ±s ）	性别（例）		BMI （kg/m²， ±s ）	结石大小（mm， ±s ）	麻醉ASA评分（ ±s ）	肾中度以上积水（例）	糖尿病（例）
组别	例数	年龄（岁， ±s ）	男	女	BMI （kg/m²， ±s ）	结石大小（mm， ±s ）	麻醉ASA评分（ ±s ）	肾中度以上积水（例）	糖尿病（例）
A组	38	40.2±3.2	18	22	23.1±3.5	20.2±6.5	1.87±0.58	15	08
B组	38	41.2±2.8	16	22	22.3±4.2	23.4±7.3	1.65±0.63	17	10
统计值	?	t=1.305	χ²=0.213		t=1.672	t=1.217	t=1.524	χ²=0.216	χ²=0.291
P值	?	0.20000	0.6500		0.1200	0.280	0.1500	0.642	0.5900

组别	例数	年龄（岁， ±s ）	性别（例）		BMI （kg/m²， ±s ）	结石大小（mm， ±s ）	麻醉ASA评分（ ±s ）	肾中度以上积水（例）	糖尿病（例）
组别	例数	年龄（岁， ±s ）	男	女	BMI （kg/m²， ±s ）	结石大小（mm， ±s ）	麻醉ASA评分（ ±s ）	肾中度以上积水（例）	糖尿病（例）
A组	38	40.2±3.2	18	22	23.1±3.5	20.2±6.5	1.87±0.58	15	08
B组	38	41.2±2.8	16	22	22.3±4.2	23.4±7.3	1.65±0.63	17	10
统计值	?	t=1.305	χ²=0.213		t=1.672	t=1.217	t=1.524	χ²=0.216	χ²=0.291
P值	?	0.20000	0.6500		0.1200	0.280	0.1500	0.642	0.5900

组别	例数	手术时间（min，±s ）	术后血红蛋白下降值（g/L，±s ）	术后血清胱抑素变化（μg/L，±s ）	术后1d PCT的变化（μg/L，±s ）	一期结石清除率（%）	最终结石清除率（%）	并发症发生率（%）
A组	38	70.4±14.8	5.4±2.3	103.2±66.80	23±14	63.1	86.8	23.7
B组	38	56.3±19.8	6.8±2.2	.104.0±63.2	35±17	84.2	94.4	15.8
统计值	?	t=1.005	t=0.312	t=1.663	t=0.214	χ²=4.343	χ²=0.325	χ²=0.748
P值	?	0.035	0.0700	0.102	0.0800	0.037	0.430	0.387

组别	例数	手术时间（min，±s ）	术后血红蛋白下降值（g/L，±s ）	术后血清胱抑素变化（μg/L，±s ）	术后1d PCT的变化（μg/L，±s ）	一期结石清除率（%）	最终结石清除率（%）	并发症发生率（%）
A组	38	70.4±14.8	5.4±2.3	103.2±66.80	23±14	63.1	86.8	23.7
B组	38	56.3±19.8	6.8±2.2	.104.0±63.2	35±17	84.2	94.4	15.8
统计值	?	t=1.005	t=0.312	t=1.663	t=0.214	χ²=4.343	χ²=0.325	χ²=0.748
P值	?	0.035	0.0700	0.102	0.0800	0.037	0.430	0.387

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