斜仰卧截石位在经皮肾镜联合输尿管镜双镜联合取石术中的应用  

Application of oblique supine lithotomy position in percutaneous nephroscopy combined with ureteroscopy and double mirrors combined stone removal

作　　者：张新梅[1] 王丽[1] 赵晓俊[2] 浦金贤[2] 刘洁[1] 李峰[2] Zhang Xinmei;Wang Li;Zhao Xiaojun;Pu Jinxian;Liu Jie;Li Feng(Department of Anesthesiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of Urology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院总院麻醉手术科,215006 [2]苏州大学附属第一医院总院泌尿外科,215006

出　　处：《中国实用护理杂志》2021年第1期38-43,共6页Chinese Journal of Practical Nursing

基　　金：苏州市民生科技项目(SYS201753)。

摘　　要：目的了解传统体位与斜仰卧截石位在经皮肾镜联合输尿管镜双镜联合取石术的应用效果,探讨斜仰卧截石位的临床护理方式。方法选择苏州大学附属第一医院手术室2018年1月至2019年1月行经皮肾镜联合输尿管镜双镜联合取石术的复杂性结石患者82例为研究对象,按照随机数字表法分为对照组40例和观察组42例。对照组于麻醉后先取截石位,置入输尿管支架管后改俯卧位完成手术;观察组麻醉后摆放斜仰卧截石位完成手术,手术过程中无需更换体位。比较2组体位摆放时间、血压、心率、脉搏血氧饱和度、输血、出血、术后体位舒适度及并发症。结果在体位摆放时和手术结束时,对照组患者血压分别为(109±31)、(106±23)mmHg(1 mmHg=0.133 kPa),心率分别为(93±10)、(95±15)次/min;观察组患者的血压为(130±19)、(125±17)mmHg,心率为(86±12)、(85±9)次/min,2组比较差异有统计学意义(t值为2.86~4.26,P<0.01)。观察组的体位摆放时间(12.4±3.0)min,对照组(21.2±6.9)min,差异有统计学意义(t值为7.550,P<0.01)。观察组患者术后不适感3例,对照组7例,差异有统计学意义(χ^2值为2.450,P<0.05)。结论双镜联合取石术中应用斜仰卧截石位手术体位安全可行,可减轻患者不适及并发症,有效提高手术效率和质量。Objective To understand the application effect of traditional position and oblique supine lithotomy in percutaneous nephroscopy combined with ureteroscopy combined with double lithography,and explore the clinical nursing methods of oblique supine lithotomy.Methods From January 2018 to January 2019 in our hospital,82 patients with complicated calculi who underwent percutaneous nephroscopy combined with ureteroscopy and double lithoscopy were selected,and were divided into the control group(n=40)and the observation group according to the random number table(n=42).The control group took the lithotomy position after anesthesia,placed the ureteral stent tube and changed it to the prone position to complete the operation;the observation group placed the oblique supine lithotomy position to complete the operation after anesthesia,and there was no need to change the position during the operation.The posture time,blood pressure,heart rate,pulse oxygen,blood transfusion,bleeding,postoperative postural comfort and complications of the two groups were compared.Results When placed in the position and at the end of the operation,the blood pressure of the control group was(109±31),(106±23)mmHg(1 mmHg=0.133 kPa),and the heart rate was(93±10),(95±15)times per minute;the blood pressure of the observation group was(130±19),(125±17)mmHg,the heart rate was(86±12),(85±9)times per minute,the difference between the two groups was statistically significant(t value was 2.86-4.26,P<0.01).The posture time of the observation group was(12.4±3.0)min and the control group was(21.2±6.9)min with statistically significant difference between two groups(t value was 7.550,P<0.01).The number of uncomfortable patients in the observation group after operation was 3 cases and 7 cases occurred in the control group.The difference was statistically significant(χ^2 value was 2.450,P<0.05).Conclusion It is safe and feasible to use the oblique supine lithotomy position in double-lens combined stone removal,which can reduce the patient's discomfort a

关 键 词：护理 斜仰卧截石位 复杂性结石 双镜联合取石术 

分 类 号：R473.6[医药卫生—护理学]