头高臀低20°斜卧位对输尿管软镜碎石术患者结石残留和生命体征的影响  

Effects of an oblique supine lithotomy position with 20°head elevation on calculus residue and vital signs in patients undergoing flexible ureteroscopy lithotripsy

作　　者：李妍 刘青 张丽 LI Yan;LIU Qing;ZHANG Li(Operating Room,the People’s Hospital of SND,Jiangsu,Suzhou 215129,China)

机构地区：[1]苏州高新区人民医院手术室,江苏省苏州市215129

出　　处：《河北医药》2023年第19期2941-2944,共4页Hebei Medical Journal

基　　金：苏州市医学重点扶持学科建设项目(编号:SZFCXK202110)。

摘　　要：目的探讨头高臀低20°斜卧位在输尿管软镜碎石术中的应用效果。方法2019年9月至2022年7月,选取行输尿管软镜碎石术的92例患者,按照随机数字表法分为试验组和对照组,每组46例。对照组术中采用常规截石位,试验组采用头高臀低20°斜卧位。比较2组患者体位摆放时间、手术时间、住院时间、结石移位率、结石残留率以及术中生命体征和术后并发症发生情况。结果试验组手术时间为(58.67±10.39)min,少于对照组的(64.76±12.35)min;试验组结石移位率为4.4%(2/46),结石残留率为4.4%(2/46),均低于对照组的17.4%(8/46)和21.7%(10/46),差异有统计学意义(t=2.56,χ^(2)=4.04,6.13,均P<0.05)。2组患者手术各时段平均动脉压、心率、血氧饱和度的差异无统计学意义(P>0.05);术后试验组发生并发症5例,对照组发生并发症7例,2组患者并发症严重程度比较差异无统计学意义(P>0.05)。结论头高臀低20°斜卧位下行输尿管软镜碎石术可缩短手术时间,减少结石移位和残留率,且不增加术中风险。Objective To explore the application outcome of an oblique supine lithotomy position with 20°head elevation in patients undergoing flexible ureteroscopy lithotripsy.Methods A total of 92 patients treated with flexible ureteroscopy lithotripsy from September 2019 to July 2022 were randomly assigned to experimental group and control group according to the random number table method,with 46 cases per group.Patients in the control group were placed in the conventional lithotomy position,and those in the experimental group were placed in an oblique supine lithotomy position with 20°head elevation.The time of position placement,operation time,length of stay,the rate of stone migration,the rate of residual stone,intraoperative vital signs and postoperative complications were compared between two groups.Results The operation time was significantly shorter in the experimental group than that in the control group([58.67±10.39]min vs[64.76±12.35]min,P<0.05).The rates of stone migration(4.4%[2/46]vs 17.4%[8/46])and residual stone(4.4%[2/46]vs 21.7%[10/46])were significantly lower in the experimental group than those in the control group(t=2.56,χ^(2)=4.04 and 6.13,respectively;both P<0.05).However,there were no significant differences in the mean arterial pressure,heart rate and blood oxygen saturation between groups(P>0.05).Postoperative complications were reported in 5 cases of the experimental group,and 7 cases of the control group.There was no significant difference in the severity of complications between the two groups(P>0.05).Conclusion An oblique supine lithotomy position with 20°head elevation can shorten operation time,decrease the rates of stone migration and residual stone,and has little influence on vital signs in patients undergoing flexible ureteroscopy lithotripsy.

关 键 词：头高臀低位 输尿管软镜碎石术 输尿管结石 生命体征 

分 类 号：R693.4[医药卫生—泌尿科学]