关键词: 肾结石, 负压吸引清石鞘, 经皮肾镜取石术, 疗效, 术后感染, 影响因素

Abstract: Objective To investigate the therapeutic effect and postoperative complications of negative pressure suction stone clearing sheath assisted percutaneous nephrolithotomy(PCNL) applied to kidney stones,and to analyze the influence of postoperative complicated infection.Methods The clinical data of 260 renal stone patients who underwent PCNL in our hospital from January 2020 to October 2022 were reviewed,divided into negative pressure suction group(118 cases) versus control group(142 cases) according to whether negative pressure stone clearing sheath was applied intraoperatively,and the baseline data,perioperative conditions as well as postoperative complications were statistically compared between the two groups.We further divided the infected group into infected group vs.uninfected group according to whether postoperative intercurrent infection was observed,and the data of the two groups were recalibrated,and multivariate logistic regression model was used to analyze the factors related to postoperative intercurrent infection after PCNL in patients with renal stones.Results There were no significant differences in baseline data such as gender,age,BMI,stone location,and stone length diameter between the two groups(P>0.05),and there were no significant differences in perioperative conditions such as operation time,intraoperative blood loss,and stone clearance rate(P>0.05).However,the postoperative hospital stay in the negative pressure suction group was shorter than that in the control group(P<0.05).The incidence of abnormal blood routine [6.78%(8/118) vs.17.61%(25/142)] and SIRS [5.08%(6/118) vs.14.08%(20/142)] in the negative pressure suction group were lower than those in the control group(P<0.05).Multivariate Logistic regression analysis showed that:BMI≥25kg/m2(OR=4.329),diabetes mellitus(OR=3.096),stone diameter ≥3.0cm(OR=2.905) were independent risk factors for postoperative infection in patients with renal calculi after PCNL(P<0.05).Negative pressure suction of stone sheath(OR=0.305) was a protective factor for postoperative infection in patients with renal calculi after PCNL(P<0.05).Conclusion PCNL assisted by negative pressure suction Qingshi sheath can significantly reduce the incidence of postoperative infection in patients with kidney stones,and is conducive to rapid postoperative recovery.BMI≥25kg/m2,diabetes mellitus and stone diameter ≥3.0cm are risk factors for postoperative infection.

Key words: renal calculi, negative pressure suction clear stone sheath, percutaneous nephrolithotomy, efficacy, postoperative infection, influencing factors