在迷你皮切性腎上腺切除手術時,腎內壓力升高是否會增加手術後的疼痛? 这就是为什么我喜欢它
Ziv Savin1, Kavita Gupta2, Christopher Connors2
1Department of Urology, Icahn School of Medicine at Mount Sinai, 424 W. 59th Street, Suite 4F, New York, 10019, United States. zivsavin23@gmail.com.
Urolithiasis
|September 10, 2025
概括
皮肤穿神经切除术 (PCNL) 期间的内压力 (IRP) 与术后疼痛没有相关性,无论管道大小如何. 这些发现挑战了PCNL程序的30mmHgIRP值.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 脊髓石切除术 (nephrolithotomy) 是一个切除术.
- 疼痛管理 疼痛管理
背景情况:
- 在迷你穿皮神经切除术 (PCNL) 期间的高内压力 (IRP) 被怀疑会增加术后疼痛.
- 没有先前的研究研究了IRP和迷你PCNL中的疼痛之间的相关性.
- 这项研究旨在评估不同管道大小的IRP和直接术后疼痛之间的关系.
研究的目的:
- 为了确定内压力 (IRP) 是否与手术后疼痛相关,在接受小型皮肤利切除术 (PCNL) 的患者中.
- 为了比较标准 (24fr),吸管-迷你 (16fr) 和非吸管-迷你 (17.5fr) PCNL通道的IRP和疼痛得分.
主要方法:
- 30名患者被分为三个PCNL组:标准,吸入型微型和非吸入型微型.
- 通过使用一种新的压力传感导线,持续监测内压力 (IRP).
- 术后疼痛是使用视觉模拟量表 (VAS) 在麻醉后护理单位 (PACU) 评估的.
主要成果:
- 中位数平均IRP为7mmHg,最大IRP为50mmHg,两组之间没有显著差异.
- 不同管道大小之间没有观察到平均或最大VAS疼痛得分的显著差异.
- 在最大IRP和术后疼痛得分之间没有发现显著的关联.
结论:
- 在PCNL期间,不论管道大小如何,内压力 (IRP) 仍然相对较低.
- 在最大IRP水平和术后疼痛之间没有可证明的关联.
- 这些发现质疑常被引用的30mmHgIRP值的临床相关性,表明需要重新评估.
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