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目的:探讨45°斜仰卧位在经皮肾镜取石术中的应用效果。方法:选择2013年1月—2014年12月肾结石患者80例,随机分为实验组和对照组,实验组实施超声引导下45°斜仰卧位经皮肾镜取石术,对照组采用俯卧位经皮肾镜取石术,并对患者的手术时间、出血量、结石取尽率、并发症、安全性等资料进行统计分析。结果:所选患者经皮肾镜取石术顺利完成,无一例出现中转手术。45°斜仰卧位安置后血压、心率及血氧饱和度较俯卧位更稳定,其手术时间指标优于俯卧位,术中出血量、一次清石率无明显差异。45°斜仰卧的手术时间为(61.9±20.2)min,术中出血量为(190.8±20.8)m L,1例需术中输血,结石清除率为95.0%,无胸膜、腹腔脏器损伤等并发症发生。结论:采用45°斜仰卧位进行经皮肾镜取石术具有体位舒适、操作方便等优点,不影响患者的呼吸,而且麻醉师能清楚地观察患者的生命体征,尤其适用于高龄、高危肾结石患者。
Objective: To investigate the effect of 45 ° oblique supine position in percutaneous nephrolithotomy. Methods: 80 patients with nephrolithiasis from January 2013 to December 2014 were randomly divided into experimental group and control group. The experimental group underwent ultrasound-guided percutaneous nephrolithotomy with 45 ° oblique supine position and the control group with prone position Percutaneous nephrolithotomy was performed and statistical analysis was performed on the patient’s operation time, amount of bleeding, stone exhaustion rate, complications and safety. Results: The selected patients underwent percutaneous nephrolithotomy successfully completed, no case of transit surgery. The blood pressure, heart rate and oxygen saturation after 45 ° oblique supine position were more stable than those in prone position. The indexes of operation time were superior to those in prone position. There was no significant difference in the amount of bleeding during operation and the rate of primary clear stone. 45 ° oblique supine operation time was (61.9 ± 20.2) min, intraoperative blood loss was (190.8 ± 20.8) m L, 1 case required intraoperative blood transfusion, stone clearance rate was 95.0%, no pleural, abdominal organ damage Complications occur. Conclusion: Percutaneous nephrolithotomy using 45 ° oblique supine position has the advantages of comfortable position and convenient operation, does not affect the patient’s breathing, and the anesthesiologist can clearly observe the vital signs of the patient, especially for elderly and high-risk kidney stones patient.