玩得安全:双边柔性尿道镜检查结石后的功能
Alexandre Danilovic1, Caio Vinicius Suartz2, Fabio Cesar Miranda Torricelli2
1Urology, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar, 255, 7 and. Sala 7175, São Paulo, SP, 05403-000, Brazil. alexandre.danilovic@hc.fm.usp.br.
针对结石的双边柔性尿路透镜 (fURS) 可以导致暂时的功能下降. 选择患者并将手术时间限制在120分钟以下是防止fURS后功能恶化的关键.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科手术的结果
背景情况:
- 结石是一种常见的疾病,需要治疗.
- 柔性尿道透视 (fURS) 是一种微创手术,用于切除结石.
- 评估外科手术期间的功能对于患者的安全至关重要.
研究的目的:
- 为了确定双边柔性尿路透镜术 (fURS) 后功能恶化的危险因素.
- 为了评估fURS对双边结石患者功能的影响.
主要方法:
- 对30名接受双边fURS治疗结石的成年患者进行前性研究 (2016年8月 - 2020年2月).
- 血清肌素和估计的球过率 (eGFR) 在手术前和手术后立即测量,POD 3,10,30.
- 使用多变量分析来确定EGFR下降的风险因素.
主要成果:
- 在手术后立即和POD3时观察到EGFR的显著下降,在POD10和30时正常化.
- 超过73%的患者经历了>10%的eGFR下降,23.3%的患者经历了>30%的下降.
- 较低的手术前eGFR,ASA>1,以及较长的手术时间被确定为eGFR下降的风险因素.
结论:
- 双边fURS导致功能可逆性下降.
- 仔细选择患者,并将手术时间限制在120分钟以下,对于预防fURS后的急性损伤至关重要.
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