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目的:评价等离子电凝在微通道经皮肾镜操作通道止血应用中的有效性和安全性。方法:我院于2015年1月~2016年6月行经皮肾镜取石术263例,对其中术中发现操作通道存在动脉性出血的83例随机分成电凝组和对照组,电凝组应用等离子针状电极实施通道止血。比较两组间的术前资料、术后住院时间、手术时间、结石清除率、血红蛋白下降值、SRAE率、输血率、SIRS发生率、肾周积液发生率和肾周血肿发生率。结果:两组间术前各项指标对照分析差异均无统计学意义,具有可比性。电凝组术后住院时间、术后血红蛋白下降值优于对照组,差异有统计学意义(P<0.05);两组间手术时间、结石清除率、输血率、SRAE率、SIRS发生率、肾周积液发生率和肾周血肿发生率差异均无统计学意义。结论:等离子电凝明显减少和控制了微通道经皮肾镜操作通道的出血。该技术安全有效,易于临床推广应用。
OBJECTIVE: To evaluate the efficacy and safety of plasma coagulation in the application of micro-channel percutaneous nephrolithotomy to hemostasis. Methods: From January 2015 to June 2016, 263 patients underwent percutaneous nephrolithotomy were randomly divided into electrocoagulation group and control group, of which 83 cases were found to have arterial bleeding in the operation channel. Electrocoagulation group was used Plasma needle electrodes to implement channel hemostasis. Preoperative data, postoperative hospital stay, operation time, stone clearance, hemoglobin decrease, SRAE rate, blood transfusion rate, incidence of SIRS, incidence of perirenal effusion and incidence of perirenal hematoma were compared between the two groups. Results: There was no significant difference between the two groups in the preoperative control of each index, which was comparable. The length of postoperative hospital stay and the postoperative hemoglobin decrease in the electrocoagulation group were significantly higher than those in the control group (P <0.05). The operative time, stone clearance rate, blood transfusion rate, SRAE rate, incidence of SIRS, Weekly effusion and perirenal hematoma incidence differences were not statistically significant. CONCLUSIONS: Plasma coagulation was significantly reduced and hemorrhage was controlled in the microchannel percutaneous nephrolithotripsy. The technology is safe and effective, easy to promote clinical application.