三种不同体位行微创经皮肾镜钬激光碎石术疗效分析

Comparative study of three different positions used in percutaneous nephrolithotomy lithotripsy

目的回顾性总结我院在三种体位下行微创经皮肾镜钬激光碎石术的临床疗效并进行分析。方法回顾性分析我院自2009年1月至2013年12月收治的结石患者,分别在俯卧位、侧卧位以及斜侧仰卧位下行经皮肾镜钬激光碎石术,对三种体位下患者的结石清除率、手术时间、出血量、并发症等进行分析。结果三组患者在年龄、性别、结石的部位、结石面积等方面比较差异无统计学意义,但斜侧仰卧位组在合并症方面与其他两组比较,差异具有统计学意义(P<0.05);三组患者术后疗效比较,斜侧仰卧位SFR明显优于其他两组,与其他两组比较,差异具有统计学意义(P<0.05);在手术并发症方面,斜侧仰卧位组明显低于其他两组,差异具有统计学意义(P<0.05);在体位舒适性方面,斜侧仰卧位明显优于其他两组,差异具有统计学意义(P<0.05)。结论斜侧仰卧位经皮肾镜钬激光碎石术在结石清除率、出血量、并发症等方面明显优于俯卧位和侧卧位,安全、有效。

Objective To investigate the safty and efficacy of three kinds of lithotomy positions on patients operated with minimally invasive percutaneous nephrolithotomy lithotripsy （mPCNL）. Methods From January 2009 to December 2013, 433 patients underwent mPCNL were randomly divided into the prone position,lateral position,and 45° supine anterolateral lithotomy position groups.To compare the stone-free rate operation time,blood loss and complications after operate. Results All operations were successful. The blood loss,stone -free rate, complications and position comfort after one session by 45° supine anterolateral lithotomy position were significantly advantageous compared with the other body positions. Conclusions mPCNL with the patients at semi-supin eanterolateral position is safe,effective and minimally invasive for the treatment of upper urinary calculi.