摘要
目的:探讨斜仰截石位经皮肾镜碎石取石术的临床应用价值。方法:随机选取2015年10月-2017年10月本院泌尿外科收治的180例上尿路结石患者,按照随机数字表法分为两,每组各90例。A组采用传统俯卧位,B组采用斜仰截石位。所有患者在连续硬膜外麻醉或全麻下完成标准手术治疗。比较两组患者术中情况(手术时间、输血率)及术后情况(一期结石除净率、术后并发症、术后住院时间)等指标。结果:(1)术中情况:B组手术时间(90.0±10.5)min明显低于A组(125.0±15.5)min(P<0.05);B组输血率1.11%与A组2.22%比较,差异无统计学意义(P>0.05)。(2)术后情况:B组一期结石除净率为94.4%,明显高于A组80.0%(P<0.05)。并发症情况:B组2例(1例因出血需介入手术止血,1例严重尿源性脓毒血症),A组共出现3例(1例因出血需介入手术止血,2例严重尿源性脓毒血症),两组比较差异无统计意义(P>0.05)。B组住院时间(9.1±1.2)d与A组(9.9±1.6)d比较差异无统计学意义(P>0.05)。结论:斜仰截石位下行经皮肾镜碎石取石术,手术时间短、一期结石除净率高,并发症发生率与传统体位相当,具有较高临床应用价值,值得在临床上推广应用。
Objective：To explore the clinical application value of supine anterolateral lithotomy position in percutaneous nephrolithotomy.Method：from October 2015 to October 2017,a total of 180 patients with upper urinary calculi admitted to our hospital were selected,they were divided into two groups according the randomly table number,90 cases in each group.The group A was given traditional prone position,group B was given supine anterolateral lithotomy position.All patients underwent standard surgical treatment under continuous epidural anesthesia.The intraoperative conditions（surgical time, blood transfusion rate） and postoperative conditions（rendere free of stones by the initial operation,postoperative complications, postoperative hospital stay） of the two groupswere compared.Result：（1）Intraoperative situation：operation time of group B was（90.0±10.5） min significantly lower than group A of（125.0±15.5） min（P〈0.05）.Compared two groups of blood transfusion rates,there was no significant difference between group A（2.22%） and group B（1.11%）（P〉0.05）.（2）Postoperative condition：the rate of the first stage calculi removal in group B was 94.4%,significantly higher than that in group A（80.0%）（P〈0.05）.There were 2 cases（1 case of bleeding requires intervention to stop bleeding, 1 case of severe urinary sepsis） in group B, and 3 cases（1 case of bleeding requires intervention to stop bleeding, 2 cases of severe urinary sepsis） in group A, the data difference was not statistically significant（P〉0.05）.In terms of length of hospital stay, there was no significant difference between group B of（9.1±1.2） d and group A of（9.9±1.6）d（P〉0.05）.Conclusion：Percutaneous nephrolithotomy in supine anterolateral lithotomy position,with short operation time,high rate of the first stage calculi removal,the incidence of complications was similar to that of traditional prone position,has high clinical application value and it is worthy of promoting.
作者
何问理
温海东
童鹏
李梓
宋少辉
杨俊
HE Wenli;WEN Haidong;TONG Peng(The Third Affiliated Hospital of Sun Yat-Sen University · Yuedong Hospital,Meizhou 514700,China)
出处
《中国医学创新》
CAS
2018年第16期65-68,共4页
Medical Innovation of China
基金
梅州市科技计划项目(2015B081)
关键词
经皮肾镜取石术
俯卧位
斜仰截石位
尿路结石
Pereutaneous nephrolithotomy
Prone position
Supine anterolateral lithotomy position
Ulinary stones
