45°斜仰卧位与俯卧位经皮肾镜取石术治疗复杂性肾结石的效果研究  

The effect of 45°oblique supine position and prone position in percutaneous nephrolithotomy for patients with complex renal calculi

作　　者：孟杰 李海波[1] Meng Jie;Li Haibo(Department of Urology,the 901th Hospital of the Joint Service Support Force of the Chinese Peoples Liberation Army,Hefei 230031,China)

机构地区：[1]中国人民解放军联勤保障部队第901医院泌尿外科,合肥230031

出　　处：《国际泌尿系统杂志》2021年第3期480-483,共4页International Journal of Urology and Nephrology

摘　　要：目的对比45°斜仰卧位与俯卧位经皮肾镜取石术(PCNL)治疗复杂性肾结石的效果:方法选取2017年6月至2019年6月本院收治的60例接受PCNL的复杂性肾结石患者作为研究对象,采用随机数字表法将60例患者分为观察组和对照组,每组各30例.观察组患者术中采用45°斜仰卧位,对照组患者术中采用俯卧位。记录并比较两组患者的围手术期心率、血流动力学指标、手术时间、术中出血量、肾造瘘管留置时间、术后住院时间、结石清除率以及术后的并发症发生率。结果观察组麻醉后30min(T2)、手术结束时(T3)及术后30min(T4)心率、收缩压(SBP)及舒张压(DBP)均高于对照组,差异有统计学意义(P<0.05)。观察组的手术时间、术后肾造瘘管留置时间及术后住院时间均短于对照组(P<0.05),术中出血量较对照组显著减少(P<0.05),术后并发症总发生率低于对照组,差异有统计学意义(P<0.05)。两组的结石清除率比较,差异无统计学意义(P>0.05)。结论复杂性肾结石患者PC-NL术中采用45°斜仰卧位体位较俯卧位安全性更高,有助于缩短手术时间和术后康复进程。Objective To compare the efect of 45°oblique supine position and prone position in percutaneous nephrolithotomy(PCNL)for patients with complex renal calculi.Methods From June 2017 to June 2019,60 patients with complex renal caleuli who received PCNL were as the re-search objects,60 patients were divided into the observation group and the control group by random number table method,30 in each group.The patients in the observation group were received the 45。ob-lique supine position,the patients in the control group were in prone position.The results of the opera-tion in the two groups were compared,the perioperative heart rate and hemodynamie indexes were recor-ded,and the postoperative complications were compared between the two groups.Results The opera-tion time,indwelling time of nephrostomy tube and hospitalization time in the observation group were shorter than those in the control group,and the amount of bleeding in the observation group was signifi-cantly higher than those in the control group,the difference were statistically signifcant(P<0.05).There was no significant difference in stone clearance between the two groups(P>0.05).The heart rate,systole blood pressure(5BP)and diastolic blood pressure(DBP)at 30 minutes atter anesthesia(T2),at the end of operation(T3)and 30 minutes after operation(T4)in the observation group were lower than those in the control group.the diferences were statistically signifcant(P<0.05).The total incidence of postoperative complications in the observation group was lower than that in the control group,the diference was statistically significant(P<0.05).Conclusions The 45°oblique supine po-sition in the patients with complex renal calculi in PCNL is more safe than prone position,which is helpful to shorten operation time and recovery process.

关 键 词：肾结石 肾造口术 经皮 仰卧位 俯卧位 

分 类 号：R699.2[医药卫生—泌尿科学]