俯卧位与斜卧位经皮肾镜碎石术疗效比较

Comparison of curative effect of prone position and recumbent position in percutaneous nephrolithotomy

目的比较俯卧位与斜卧位行经皮肾镜碎石术的临床疗效。方法 368例行经皮肾镜碎石术患者分为俯卧位组(299例)和斜卧位组(69例),对2组患者手术出血量、手术时间、术后肾造瘘管留置时间、术后住院时间、手术并发症以及穿刺的深度和方向进行比较。结果斜卧位组患者手术出血量少于俯卧位组(P<0.05),手术时间短于俯卧位组(P<0.05);但2组患者手术后肾造瘘管放置时间及术后住院时间比较差异无统计学意义(P>0.05)。斜卧位组并发症发生率显著低于俯卧位组(P<0.05);斜卧位组穿刺路径长于俯卧位组(P<0.05)。结论超声引导下斜卧位行经皮肾镜碎石术疗效确切,安全可行。

Objective To compare the clinical effect of prone position and recumbent position in percutaneous nephrolithotomy.Methods Three hundred and sixty-eight cases of percutaneous nephrolithotomy were divided into prone position group（n=299） and recumbent position group group（n=69）.The operation blood loss,operation time,postoperative renal fistula indwelling time,stay time of hospital,operative complication,the depth and angle of puncture were compared between two groups.Results Compared with prone position group,the operation blood loss was fewer（P〈0.05）,and the operation time was shorter in recumbent position group（P〈0.05）.There was no significant difference in the postoperative renal fistula indwelling time and stay time of hospital between two groups（P〈0.05）.Compared with prone position group,the complication incidence rate was significantly lower（P〈0.05）,and the depth of puncture was longer in recumbent position group（P〉0.05）.Conclusion Recumbent position in percutaneous nephrolithotomy by ultrasonic guidance is safe and feasible with preonunced curative effect.