摘要
目的分析体位对经皮肾镜碎石取石术(PCNL)治疗肾结石的效果与安全性的影响。方法选择2012年1月至2015年1月我院收治的76例肾结石患者,随机分为对照组与观察组两组,各38例。两组均接受PCNL术,对照组采用俯卧位,观察组采用斜卧截石位,观察两组手术情况,统计体位安置前后患者血压、心率的变化,记录建立通道时间、手术时间、术中出血量、住院时间,比较围术期不良反应及并发症,统计输血率、再次手术率、结石取净率。结果体位安置后,两组血压均下降,观察组下降幅度低于对照组(P<0.05),但两组心率对比差异无统计学意义(P>0.05);观察组手术时间、住院时间均短于对照组,术中出血量少于对照组,对比差异有统计学意义(P<0.05);观察组输血率、再次手术率均低于对照组,结石取净率高于对照组,对比差异有统计学意义(P<0.05);观察组胸闷、躁动发生率低于对照组,对比差异有统计学意义(P<0.05),其胸膜损伤、感染、出血、肾损伤发生率均略低于对照组,但对比差异无统计学意义(P>0.05)。结论在肾结石患者的临床治疗中,采用斜卧位PNCL治疗,患者术中舒适度好,安全性高,并发症发生率低。
Objective To evaluate the effect of body position on the effects and safety of pcrcutaneous nephrolithotomy （PCNL） for the treatment of renal calculi. Methods 76 patients with renal calculi who were admitted in our hospital between January 2012 and January 2015 were randomly divided into the control group and the observation group, with 38 cases in each group. Both of the two groups were treated with PCNE. Patients in the control group were in prone position while the observation group in recumbency lithotomy position. The operatious in the two groups were compare. The changes of blood pressure and heart rate in patients belbre and after position placement were analyzed. Tile time of establishing tunnel, operation time, intraoperative blood loss and duration of hospital stay were recorded and compared. Tile perioperative adverse reactions and complications were compared. The rate of blood transfusion, rate of reopcration and rate of complete stone removal were analyzed. Results After the position changed, blood pressure of the two groups decreased, and the decreased range in tile observation g^oup was lower than that ira the control group （P〈0.05）, but no significant difference in heart rate between the two groups （p〉0.05）. The operation time and duration of hospital stay in the obselwation group was shorter than that in the contaol group and the intraoperative blood loss was less than that of the control group （P〈0.05）. The rates of blood transfusion and reoperation in the observation group were lower than those in the control group while the rate of complete stone removal was higher than that in the control group
出处
《中华腔镜泌尿外科杂志（电子版）》
2016年第4期26-29,共4页
Chinese Journal of Endourology(Electronic Edition)
关键词
肾造口术
经皮
肾结石
俯卧位
斜卧截石位
安全性
Pcrcutaneous nephrolithotonay
Renal calculi
Prone position
Recumbencylidlotonly positiom Safct
