不同麻醉方式下行微通道经皮肾镜碎石术治疗上尿路结石的效果对比  

Comparison of the Effects of Microchannel Percutaneous Nephrolithotomy under Different Anesthesia methods in the Treatment of Upper Urinary Calculi

作　　者：陆荣森[1] 梁华良[1] 黄广龙[1] 黄芳伟[1] 梁多[1] LU Rongsen;LIANG Hualiang;HUANG Guanglong;HUANG Fangwei;LIANG Duo(Xinyi City People’s Hospital,Guangdong Province,Xinyi 525300,China;不详)

机构地区：[1]广东省信宜市人民医院,广东信宜525300

出　　处：《中国医学创新》2022年第4期39-43,共5页Medical Innovation of China

基　　金：广东茂名市科技计划立项项目(2019165)。

摘　　要：目的:探讨不同麻醉方式下行微通道经皮肾镜碎石术治疗上尿路结石的效果。方法:选取2020年1月-2021年1月信宜市人民医院收治的110例行微通道经皮肾镜碎石术治疗的上尿路结石患者作为研究对象,以随机数字表法将其分为对照组和观察组,各55例。对照组给予腰硬联合麻醉,观察组给予局部麻醉。对比两组麻醉前后血流动力学指标、手术前后肾功能指标和术后并发症发生情况。结果:麻醉后,两组心率均较麻醉前明显上升,血氧饱和度、平均动脉压均较麻醉前明显下降(P<0.05),与对照组相比,观察组心率更低,血氧饱和度、平均动脉压更高(P<0.05)。术毕以及术后3 d,两组各肾功能指标水平均较术前明显上升(P<0.05),与对照组相比,观察组血尿素氮水平、血肌酐水平和尿微量白蛋白水平均明显低于对照组(P<0.05)。观察组术后并发症发生率为9.09%低于对照组的12.73%,但两组比较差异无统计学意义(P>0.05)。结论:与腰硬联合麻醉相比,局部麻醉用于微通道经皮肾镜碎石术治疗上尿路结石对患者血流动力学各项指标影响较小,且可保护肾功能,可优先选择。Objective:To explore the effect of microchannel percutaneous nephrolithotomy under different anesthesia methods in the treatment of upper urinary calculi.Method:A total of 110 patients with upper urinary calculi treated by microchannel percutaneous nephrolithotripsy in Xinyi City People’s Hospital from January 2020 to January 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 55 cases in each group.The control group was given combined spinal-epidural anesthesia,and the observation group was given local anesthesia.Hemodynamic indexes before and after anesthesia,renal function indexes before and after operation and postoperative complications were compared between the two groups.Result:After anesthesia,the heart rate of both groups increased significantly compared with that before anesthesia,and blood oxygen saturation and mean arterial pressure decreased significantly compared with those before anesthesia (P<0.05),compared with the control group,the heart rate of observation group was lower,blood oxygen saturation and mean arterial pressure were higher (P<0.05).After surgery and 3 d after surgery,the levels of renal function indexes in two groups were significantly increased compared with those before surgery (P<0.05),and the levels of blood urea nitrogen,serum creatinine and urinary microalbumin in observation group were significantly lower than those in control group (P<0.05).The incidence of postoperative complications in the observation group was 9.09%,lower than 12.73% in the control group,but there was no statistical significance between the two groups (P>0.05).Conclusion:Compared with combined spinal-epidural anesthesia,local anesthesia used for micro-channel percutaneous nephrolithotomy for upper urinary calculi has less impact on the hemodynamic indicators of patients,and can protect renal function,it can be preferred.

关 键 词：上尿路结石 微通道经皮肾镜碎石术 局部麻醉 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]