局麻经皮肾镜碎石取石术临床应用探讨

Treatment of upper urinary tract stones with percutaneous nephrolithotomy under the guidance of local infiltration anesthesia

目的 观察局麻经皮肾镜碎石术( PCNL)治疗上尿路结石的可行性和有效性.方法 选择上尿路结石120 例,随机分为观察组60 例和对照组60 例.观察组采用局麻下行PCNL治疗,对照组采用气管插管全麻下行PCNL治疗.比较分析两种麻醉方式下的术后残石率、手术时长、术前忧虑程度、术后住院时长、住院费用、术后疼痛及并发症、手术前后炎性指标、血红蛋白等情况.结果 观察组术前忧虑程度、术后住院时间、术后活动时间、术后进食时间及住院费用、炎性指标等情况均优于对照组( P<0. 05).结论 局麻用于PCNL手术具有操作简便、安全有效,术后恢复快,费用低等优点,符合快速康复外科值得推广.

Objective To compare the safety and efficacy of percutaneous nephrolithotomy(PCNL)performed under local anesthesia(LA).Methods From June 2017 to September 2018,120 patients with renal stones who underwent percutaneous nephrolithotomy were randomly enrolled into general anesthesia group(n=60)and local anesthesia group(n=60).The residual stone rate,length of surgery,preoperative anxiety,postoperative hospital stay,hospital costs,postoperative pain and complications in both groups were compared.Results There were statistically significant in preoperative anxiety,postoperative hospital stay,hospital costs,postoperative activity time,postoperative feeding time between the two groups(P<0.05).Conclusions Local anesthesia is feasible and safe in PCNL operations,it has the advantages of quick recovery and low cost.It is worth to be applied.