ABSTRACT
Objective To compare intrarenal pelvic pressure or endoureteral pressure and infection index between perfusion pump and low pressure of gravity drip during percutaneous nephrolithotomy (PCNL). Methods From 2015 April to 2017 June, 107 patients with ureteral or renal calculus were randomly divided into two groups, among whom 46 cases underwent perfusion pump PCNL and 61 cases underwent low pressure gravity drip PCNL. No statistical significance of preoperative variables was found between the two groups such as age, gender,preoperative status of infection,status of hydrpnephrosis,size and location of stone (P＞0.05).A 5Fr ureteral catheter was positioned into the renal pelvic or ureter,and the intrarenal pelvic or endoureteral pressure was measured by anesthesia monitor during PCNL for all patients.We recorded and compared removing calculus time, postoperative hemoglobin changing, fever rate, procalcitonin abnormal rate, white blood cell counts and calculi clearance rate.Results The average pelvic or endoureteral pressures in the group undergoing perfusion pump and the one undergoing low pressure gravity drip were (22.7±4.6) mmHg VS (29.8±5.3) mmHg and the maximum pressure were (28.8 ±6.56) mmHg VS (50 ±9.25) mmHg.The statistics was significantly different (P＜0.05).Compared with perfusion pump group, the group undergoing low pressure gravity drip had significant differences in fever rate [4.9%(3/61) VS.17.3%(8/46) ], procalcitonin abnormal rate [3.2%(2/61) VS. 15.2%(7/46) ] and white blood cell counts abnormal rate[9.8%(6/61) VS.28.26%(13/46) ] (P＜0.05). However,no significant difference was seen in postoperative hemoglobin changing[(8.3±3.7) g/L VS.(7.2 ± 3.3) g/L] (P＞0.05) and the time of removing calculus [(42.4 ±14.5) min VS (43.6 ±13.5) min] (P＞0.05) .Conclusions Compared with perfusion pump, low pressure gravity drip PCNL maintains lower renal pelvic or endoureteral pressure, which is less than reflux limit during calculi fragmentation. It might be contributed to reduce the postoperative fever rate, white blood cell counts abnormal rate and procalcitonin abnormal rate. Hemoglobin changing and the time of removing calculus show no obvious disadvantage.