俯卧分腿位与传统俯卧位经皮肾镜取石术治疗上尿路结石的疗效比较  

Comparison of Efficacy Between Prone Split-leg Position and Traditional Prone Position Percutaneous Nephrolithotomy for Upper Urinary Tract Stones

作　　者：孙炜斌 哈木拉提·吐送[1] 阿衣丁·西热牙孜旦 阿斯木江·阿不拉[1] 乃比江·毛拉库尔班[1] 斯迪克江·尼亚孜 高新[1] 夏韩 宋光鲁[1] Sun Weibin;Hamulati Tusong;Ayiding Xireyazidan(Department of Urology Surgery,First Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院泌尿外科,乌鲁木齐830011

出　　处：《中国微创外科杂志》2024年第2期92-97,共6页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨俯卧分腿位在经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)中的应用效果。方法2021年7月~2022年7月我科79例上尿路结石行PCNL,根据手术体位分为俯卧分腿位组35例,传统俯卧位组44例,比较2组手术时间、手术出血量、术后与术前血红蛋白变化、术后并发症、一期结石清除率、住院时间等指标。结果俯卧分腿位组手术时间(69.6±20.7)min,明显短于传统俯卧位组[(90.5±35.3)min,t=-3.280,P=0.002],一期结石清除率97.1%(34/35),明显高于传统俯卧位组79.5%(35/44)(χ^(2)=3.984,P=0.037)。俯卧分腿位组术后感染1例,发热3例,出血1例;传统俯卧位组术后发热4例,出血2例,2组并发症发生率差异无显著性(χ^(2)=0.000,P=1.000)。2组手术出血量、工作通道、血红蛋白变化和住院时间差异均无统计学意义(P>0.05)。结论俯卧分腿位行PCNL能缩短手术时间,提高一期结石清除率,且不会增加术后并发症风险,具有良好的安全性及有效性。Objective To explore the application effect of prone split-leg position in percutaneous nephrolithotomy(PCNL).Methods A total of 79 patients with upper urinary tract stones who underwent surgery in our department from July 2021 to July 2022 were selected.According to the surgical position,the patients were divided into prone split-leg position group(n=35)and traditional prone position group(n=44).The two groups were compared regarding operation time,intraoperative blood loss,postoperative and preoperative hemoglobin changes,postoperative complications,one-stage stone free rate,and duration of hospitalization.Results The prone split-leg position group had significantly shorter operative time and higher one-stage stone free rate than those in the traditional prone position group[(69.6±20.7)min vs.(90.5±35.3)min,t=-3.280,P=0.002;97.1%(34/35)vs.79.5%(35/44),χ^(2)=3.984,P=0.037].There were 1 case of infection,3 cases of fever,and 1 case of bleeding in the prone split-leg position group,while 4 cases of postoperative fever and 2 cases of bleeding in the traditional prone position group,without significant difference in the incidence of complications between the two groups(χ^(2)=0.000,P=1.000).There were no statistical differences in intraoperative blood loss,number of working channel,hemoglobin changes,and duration of hospitalization(P>0.05).Conclusion Prone split-leg position PCNL can shorten the operation time,improve the one-stage stone free rate,and will not increase the risk of postoperative complications,with good safety and effectiveness.

关 键 词：经皮肾镜取石术 肾结石 输尿管结石 俯卧分腿位 

分 类 号：R699[医药卫生—泌尿科学]