The Application Research Of Plasma Cylindrical Electrode In The Part Tubeless PCNL

Background and purpose: Percutaneous nephrolithotomy is an important surgical procedure to cure kidney stone at present. The operation of crushing and removing calculus through the passage of MPCN has less trauma to patients, which has basically replaced traditional open operation. Through 40-year development,adopting tubeless mode of processing---postoperation without nephrostomy tube,is an important development tendancy of percutaneous nephrolithotomy. However,the bleeding in and after operation is the key factor to influence the rate of success in tubeless. Unforyunately,the bleeding for percutaneous renal biopsy channel has not had a practical and efficient method.On the basis of concluding predecessors’ experience,we apply plasma hemostasis to the hemostasis process of Percutaneous renal biopsy channel, and comparatively study the result of it compared with traditional percutaneous nephrolithotomy, looking forward to proving the security and efficiency of Plsamakinetic in dealing with the channel bleeding of percutaneous renal biopsyMethods : From patients of upper urinary calculi from December 2013 to september 2015,accordance with established criteria select 40 patients and seperate them at random, of which 20 receive the tubeless percutaneous nephrolithotomy by plasma electric cogulation hemostasis(tubeless group), while the other 20 receive traditional percutaneous nephrolithotomy(traditional group). Use statistical method to comparatively analise their operating time, fever conditions,visual pain score,the usage rate of analgesic drugs,descending degree of Hb and HCT, the recovery time of gastrointestinal function, the duration and fees of postoperation hospitalization, the occurance rate of perirenal hematoma and hydrops.Result: All the 40 patients succeeded in crashing stones in the first term, no surrounding organs trauma or transferred open cases. There is no statistical differences in operating time,stone clearance rate,rate of postoperative fever andrecovery time of gastrointestinal function,the occurance rate of perirenal hematoma and hydrops between these two groups. However,in the postoperative descending degree of Hb and HCT, the VAS score of the first day after operation, the usage rate of analgesic drugs and the duration and fees of postoperation hospitalization, the tubeless is inferior to the traditional group and the difference of them has statistical significance.Conclusion: the application of Plsamakinetic to the hemostasis of the working aisle of PCNL is a secure and efficient initiative method of hemostasis. It is simple,convenient and easy to use in a narrow channel, does less thermal injury to normal structure, effectively decrease postoperation bleeding, postoperation without nephrostomy tube. Compared with traditional PCNL, it will not add postoperative complications and stimutaneously help patients’ recovery, definitely reduce postoperative pain, shrink the duration of hospitalization and save the fees of hospitalization.