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目的:探讨斜卧截石位在老年肾结石患者经皮肾镜碎石取石术(PCNL)中的应用。方法:选取2014年6月至2016年8月在肇庆市第一人民医院因肾结石接受PCNL手术的84例老年患者,随机分为观察组和对照组,对照组采用传统截石位后俯卧位,观察组采用斜卧截石位行手术。观察比较两组体位摆放时间、手术时间、结石清除率、术中生命体征变化及患者舒适度。结果:观察组患者安置体位和手术时间少于对照组(P<0.05),术中血压、心率、气道压、血氧饱和度稳定性变化均较对照组患者例数减少(P>0.05);四肢关节及躯体酸痛不适例数低于对照组;结石残留率两组无明显差异(P>0.05)。结论:采用斜卧截石位PCNL治疗老年肾结石患者能有效提升老年患者手术耐受性,缩短手术时间,减少术中出血量,减轻术后体位不适感。
Objective: To investigate the application of oblique stone lithotomy in percutaneous nephrolithotomy (PCNL) in elderly patients with kidney stones. Methods: From June 2014 to August 2016, 84 elderly patients with PCNL due to kidney stones in the First People’s Hospital of Zhaoqing City were selected and randomly divided into observation group and control group. The control group was treated by conventional lithotomy position prone position , Observation group using oblique position lithotomy surgery. Observation and comparison of body positioning time, operation time, stone removal rate, intraoperative vital signs and patient comfort. Results: The position and operation time of the observation group were less than those of the control group (P <0.05). The changes of blood pressure, heart rate, airway pressure and oxygen saturation in the observation group were less than those in the control group (P> 0.05) ; Limbs and joints and body aches and discomforts less than the control group; stone residual rate was no significant difference between the two groups (P> 0.05). Conclusion: The treatment of elderly patients with renal calculi by oblique position lithotripsy PCNL can effectively improve the surgical tolerance of elderly patients, shorten the operation time, reduce the amount of intraoperative blood loss and reduce postoperative discomfort.