全身麻醉与持续硬膜外麻醉下标准经皮肾镜取石术治疗肾结石的临床效果观察  

Clinical observation of standard percutaneous nephrolithotomy under general anesthesia and continuous epidural anesthesia for the treatment of kidney stones

作　　者：练胜强 高晓枫[1] 纪浩聪[1] LIAN Sheng-qiang;GAO Xiao-feng;JI Hao-cong(Department of Anesthesiology,Huizhou First Hospital,Huizhou 516003,China)

机构地区：[1]惠州市第一人民医院麻醉科,516003

出　　处：《中国实用医药》2023年第15期60-63,共4页China Practical Medicine

摘　　要：目的探究全身麻醉与持续硬膜外麻醉下标准经皮肾镜取石术治疗肾结石的临床效果。方法140例接受标准经皮肾镜取石术治疗的肾结石患者,根据随机数字表法分为全麻组与硬膜组,各70例。全麻组实施全身麻醉,硬膜组实施持续硬膜外麻醉。比较两组生命体征[心率(HR)、血氧饱和度(SpO2)、平均动脉压(MAP)、呼吸频率(RR)、中心静脉压(CVP)]、麻醉效果与术后不良反应发生情况。结果麻醉后,硬膜组HR(80.32±6.23)次/min、CVP(6.59±5.26)kPa、SpO2(99.65±10.21)%高于全麻组的(74.95±6.43)次/min、(4.65±3.21)kPa、(94.65±10.32)%,MAP(14.26±1.23)kPa、RR(21.42±2.13)次/min低于全麻组的(16.25±3.21)kPa、(25.62±1.53)次/min,差异有统计学意义(P<0.05)。两组麻醉总有效率比较差异无统计学意义(P>0.05)。硬膜组术后不良反应发生率4.29%低于全麻组的14.29%,差异有统计学意义(P<0.05)。结论对接受标准经皮肾镜取石术治疗的肾结石患者实施持续硬膜外麻醉,操作简单,安全性较高,可有效保持患者生命体征稳定,确保手术顺利进行。Objective To investigate the clinical effect of standard percutaneous nephrolithotomy under general anesthesia and continuous epidural anesthesia for the treatment of kidney stones.Methods A total of 140 patients receiving standard percutaneous nephrolithotomy were divided into general anesthesia group and epidural anesthesia group according to the random numerical table,with 70 cases in each group.General anesthesia was administered in the general anesthesia group,and continuous epidural anesthesia was administered in the epidural anesthesia group.Both groups were compared in terms of vital signs[heart rate(HR),blood oxygen saturation(SpO2),mean arterial pressure(MAP),respiratory rate(RR),central venous pressure(CVP)],anesthesia effect,and postoperative adverse reactions.Results After anesthesia,epidural anesthesia group had HR of(80.32±6.23)times/min,CVP of(6.59±5.26)kPa,and SpO2 of(99.65±10.21)%,which were higher than those of(74.95±6.43)times/min,(4.65±3.21)kPa,and(94.65±10.32)%in general anesthesia group;MAP of(14.26±1.23)kPa and RR of(21.42±2.13)times/min in epidural anesthesia group were lower than those of(16.25±3.21)kPa and RR(25.62±1.53)times/min in general anesthesia group;the differences were statistically significant(P<0.05).There was no statistically significant difference in total effective rate between the two groups(P>0.05).The incidence of postoperative adverse reactions of 4.29%in the epidural anesthesia group was lower than that of 14.29%in the general anesthesia group,and the difference was statistically significant(P<0.05).Conclusion Standard percutaneous nephrolithotomy under continuous epidural anesthesia for patients with kidney stones undergoing percutaneous nephrolithotomy is simple and safe,which can effectively stable patients'vital signs and ensure the smooth progress of the surgery.

关 键 词：全身麻醉 持续硬膜外麻醉 经皮肾镜取石术 肾结石 应用效果 

分 类 号：R614[医药卫生—麻醉学]