斜仰卧位经皮肾镜碎石取石术的临床观察和应用体会

Clinical observation and application experience of percutaneous nephrolithotomy in semi-supine position

目的分析经皮肾镜碎石取石术(PCNL)中应用斜仰卧位这一体位的安全性和总结经验。方法按照手术体位不同将我院2016年10月至2018年12月收治的68例接受经皮肾镜碎石取石术治疗的患者分为观察组34例、对照组34例,前组患者在经皮肾镜碎石取石术中应用斜仰卧位,对照组患者在经皮肾镜碎石取石术中选择传统体位。观察和比较两组血流动力学变化,临床应用效果和并发症。结果观察组在围术期血氧饱和度、脉搏、血压都比较平稳,对照组在体位摆放后一直到手术结束时相关指标水平有明显变化,包括术后短暂血压下降、心率增快,术中躁动发生率明显增高。两组在并发症发生和住院时间相当。结论 PCNL中体位应用斜仰卧位降低患者血压、心率变化幅度,减少操作过程中患者的躁动,手术安全。

Objective To evaluate the safety of percutaneous nephrolithotomy(PCNL) in semi . supine position and summarize the practical experience. Methods According to the different operation positions,68 patients who received PCNL in our hospital from October 2016 to December 2018 were divided into observation group(34 cases)and control group(34 cases). The former group used semi. supine position in PCNL, while the control group chose traditional position (prone position). Hemodynamic changes,clinical effects and complications were observed and compared between the two groups. Results The blood oxygen saturation,pulse and blood pressure in the observation group were relatively stable during the perioperative period. There were significant changes in the related indicators in the control group from the posture to the end of the operation,including the decrease of blood pressure and the increase of heart rate,and the incidence of intraoperative restlessness. The complications and hospitalization time of the two groups were similar. Conclusion In PCNL,the use of semi.supine position is conducive to reducing the changes of blood pressure and heart rate,reducing the agitation of patients during the operation,and the operation is safe.