在局部透麻醉下,针对上部尿路结石的中国微型皮肤穿透性腎石切除术
Zhao-Lin Zhang1, Fang-Zhi Li2, Tian-Peng Xie1
1Department of Urology, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
Medicine
|September 29, 2023
概括
在局部透麻醉 (LIA) 下的中国迷你皮肤穿透性瘤切除术 (MPCNL) 对上尿路结石是安全有效的. 这种方法在选定的患者中实现了84.6%的无石头率,并发症最小.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 麻醉学 麻醉学
背景情况:
- 皮肤透神经切除术 (PCNL) 通常使用全身或区域麻醉.
- 局部透麻醉 (LIA) 很少用于PCNL,这是一个需要研究的领域.
研究的目的:
- 通过使用LIA,评估中国微型皮肤穿神经切除术 (MPCNL) 对上尿路结石的安全性和有效性.
- 在LIA下的MPCNL期间评估患者的耐受性和疼痛管理.
主要方法:
- 根据LIA,对52名接受MPCNL治疗的患者进行了回顾性分析,以治疗上尿路结石.
- 手术前的药物包括pethidine和Phenergan;局部麻醉包括oxybuprocaine化凝和ropivacaine和lidocaine的道内注射.
- 程序使用了8/9.8F尿管镜和18F真空辅助接入.
主要成果:
- 所有52名患者在LIA下成功完成了MPCNL手术,没有麻醉转换或额外止痛.
- 视觉模拟量表 (VAS) 平均得分在整个术后期间保持低,表明有效控制疼痛.
- 无石头率为84.6%,并发症率较低 (11.5%),包括发烧,,轻微出血和尿路感染 (所有Clavien I或II).
结论:
- 根据LIA的中国MPCNL是对某些患上尿路上部结石的患者来说可行的和有效的选择.
- 该程序表现出良好的结果和有利的安全概况,表明其可能被广泛采用.
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