摘要
目的:探讨全身麻醉与腰部麻醉下标准经皮肾镜取石术(percutaneous nephrolithotomy,PCNL)对治疗肾结石的影响。方法:2017年5月至12月收集中南大学湘雅医学院附属株洲医院行标准经皮肾镜取石术的58例患者,将患者随机分为2组:全身麻醉组及腰部麻醉组。比较两组的基本资料、术中及术后的参数。结果:两组在性别、年龄、结石大小、体重、麻醉分级、手术时间、术后血红蛋白下降、术后发热发生率、术后第2天VAS评分、住院时间、结石清除率方面差异无统计学意义(P>0.05),但全身麻醉组术中低血压发生率显著高于腰部麻醉组,且全身麻醉组术后的第1天的VAS评分(6.47±1.39)显著高于腰部麻醉组(4.51±0.81,P<0.05)。结论:全身麻醉与腰部麻醉下行PCNL治疗肾结石均安全有效,在腰部麻醉下行PCNL治疗肾结石比全身麻醉下行PCNL术中低血压发生率更低、术后疼痛更轻,且住院天数较短。
Objective: To investigate the effect of percutaneous nephrolithotomy (PCNL) on the treatment of kidney stones under general anesthesia and spinal anesthesia. Methods: From May 2017 to December 2017, 58 patients underwent standard percutaneous nephrolithotomy. The patients were randomly divided into 2 groups. The first group was general anesthesia, and the second group was in the PCNL group under spinal anesthesia. The basic data, intraoperative, and postoperative parameters of the 2 groups were compared. Results: There were no significant differences in gender, age, stone size, body weight, anesthesia grade, operation time, postoperative hemoglobin decline, postoperative fever incidence, VAS score on the second postoperative day, mean hospital stay, and stone clearance rate (P>0.05). The incidence of hypotension in the general anesthesia group was significantly higher than that in the spinal anesthesia group, and the VAS score on the first day after the surgery in the general anesthesia group was significantly higher than the spinal anesthesia group (6.47±1.39 vs 4.51±0.81, P<0.05). Conclusion: PCNL is safe and effective in the treatment of renal stones with general anesthesia and spinal anesthesia. PCNL treatment of kidney stones under spinal anesthesia has lower incidence of hypotension, less postoperative pain and shorter hospital stay.
作者
瞿根义
徐勇
刘劲戈
聂海波
刘自卫
黄文琳
阳光
QU Genyi;XU Yong;LIU Jin’ge;NIE Haibo;LIU Ziwei;HUANG Wenlin;YANG Guang(Department of Urology, Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou Hunan 412007, China)
出处
《临床与病理杂志》
2018年第12期2612-2615,共4页
Journal of Clinical and Pathological Research
基金
湖南省自然科学基金(2017JJ4067)~~
关键词
肾结石
经皮肾镜取石术
全身麻醉
腰部麻醉
renal stones
percutaneous nephrolithotomy
general anesthesia
spinal anesthesia
