“骑马射箭”体位在双镜联合一期治疗复杂性肾结石中的应用  

Application of modified oblique supine lithotomy position in dual-endoscopic treatment for complex renal calculi

作　　者：姚英[1] 吴强[2] 孙晓敏[3] YAO Ying;WU Qiang;SUN Xiaomin(Operating Room,Tongji Hospital of Tongji University,Shanghai,200065;Department of Urology Surgery,Tongji Hospital of Tongji University,Shanghai,200065;Department of Nursing,Tongji Hospital of Tongji University,Shanghai,200065)

机构地区：[1]同济大学附属同济医院上海市同济医院手术室,上海200065 [2]同济大学附属同济医院上海市同济医院泌尿外科,上海200065 [3]同济大学附属同济医院上海市同济医院护理部,上海200065

出　　处：《中西医结合护理（中英文）》2019年第11期66-69,共4页Journal of Clinical Nursing in Practice

摘　　要：目的探讨改良斜仰截石位"骑马射箭位"在双镜(经皮肾镜、输尿管镜)联合一期治疗复杂性肾结石中的应用效果。方法选取2018年7月-2019年7月行双镜联合一期治疗复杂性肾结石患者440例,随机分成对照组和观察组,各220例。对照组采用截石位后侧卧位,观察组采用改良体位,即"骑马射箭位"(患者肩背部借助自制的15°斜坡垫呈15°斜仰卧位,固定后使下半身处于截石位)。观察2组术中及术后的出血情况、手术结束时的生命体征、一次清石率、术后有无并发症、体位放置时间、手术时间。结果观察组术中出血少于对照组,观察组体位放置时间短于对照组,差异有统计学意义(P<0.05)。其余指标2组差异无统计学意义(P>0.05)。结论双镜联合一期治疗复杂性肾结石术中采用改良后的"骑马射箭位"更加安全,且能节省手术时间。Objective To investigate the application value of modified oblique supine lithotomy position in dual-endoscopic(percutaneous nephroscopy and ureteroscopy) treatment for complex renal calculi. Methods Totally 440 patients with complex renal calculi undergoing dual-endoscopic treatment were randomly divided into two groups: group A(first lithotomy position then lateral position) and group B(modified oblique supine lithotomy). Each group included 220 patients. The clinical outcome including intraoperative blood loss, postoperative blood loss, vital signs at the end of surgery, one-time stone clearance rate, postoperative complications;time of position placing and duration of surgery were observed and compared between two groups. Results The observation group had a lower amount of intraoperative blood loss and shorter time of position placing compared with those in the control group(P<0.05). There were no significant differences in postoperative blood loss, one-time stone clearance rate, postoperative complications, duration of surgery between two groups(P>0.05). Conclusion The application of modified oblique supine lithotomy position is safer and can save operation time in dual-endoscopic treatment of complex renal calculi.

关 键 词：肾结石 双镜联合 经皮肾镜 输尿管镜 手术体位 手术护理 

分 类 号：R472.3[医药卫生—护理学]