不同卧位微创经皮肾镜碎石术对肾结石的疗效观察及对应激激素的影响

The effect of minimally invasive percutaneous nephrolithotomy on renal calculi and the effect of stress hormone

目的 不同卧位微创经皮肾镜碎石术对肾结石的临床疗效观察及其对应激激素的影响.方法 选取2016年12月至2017年10月本院收治的90例肾结石患者,按照随机数字法将其分为三组各30例,第一组在俯卧位下行微创经皮肾镜碎石术,第二组在侧卧位下行碎石术,第三组在斜侧仰卧位下行碎石术.分析对比三组患者手术时间、术中出血量等手术结果,术后并发症发生率以及结石清除率和应激激素的变化.结果 手术后,斜侧仰卧位组在并发症发生率方面明显低于其他两组（P＜0.05）;斜侧仰卧位组在造痿管拔除时间、结石清除率手术结果方面显著优于其他两组（P＜0.05）;治疗前,三组患者应激激素水平无明显区别（P＞0.05）,治疗后斜侧仰卧位组变化幅度显著低于其他两组（P＜0.05）.结论 斜侧仰卧位下行微创经皮肾镜碎石术在结石清除率、临床疗效以及对应激激素的影响方面较俯卧位和侧卧位更加理想,手术更加安全,值得临床上进一步推广应用.

Objective To observe the clinical effect of minimally invasive percutaneous nephrolithotripsy on renal calculi and its effect on the stress hormone.Methods From December 2016 to October 2017,90 cases of renal calculi patients in our hospital were randomly divided into three groups with 30 cases in each group,the first group of percutaneous nephrolithotomy in the prone position,the second group underwent minimally invasive,lateral descending lithotripsy,and third group underwent lithotripsy in oblique supine position.The results of operation time,intraoperative bleeding,the incidence of postoperative complications and the change of stone clearance and stress hormone were analyzed and compared among the three groups.Results After surgery,the incidence of complications of oblique supine group was significantly lower than the other two groups （P ＜ 0.05）.Extubation time,stone clearance rate of surgical results of oblique supine group was significantly better than the other two groups （P ＜0.05）.Before treatment,there was no significant difference in stress hormone levels among the three groups （P ＜ 0.05）.Variation of lateral oblique supine group after treatment was significantly lower than that of the other two groups （P ＜ 0.05）.Conclusions The minimally invasive percutaneous nephrolithotomy under the supine supine position is more ideal than the prone position and lateral position in the stone clearance rate,the clinical curative effect and the influence of the stimulating hormone.The operation is safer and worthy of further promotion and application in clinic.