斜仰卧-低截石位与俯卧位经皮肾镜碎石术治疗复杂肾结石

Comparative study of oblique supine-low litllotomy and prone position in ultrasound guided percutaneous nephrolithotomy for the treatment of complicated renal calculus

目的对比斜仰卧-低截石位与俯卧位经皮肾镜碎石术治疗复杂肾结石的临床疗效。方法分析我院2010年1月~2017年4月108例复杂肾结石患者资料,根据选择的穿刺体位将患者分为实验组(n=65)和对照组(n=43)。实验组患者采用斜仰卧低截石位,对照组患者采用俯卧位,均全身麻醉后彩超引导下穿刺。比较两组患者手术时间、术中出血量、住院时间、肾造瘘管留置时间,术后并发症发生率、一期结石清除率。结果实验组手术时间、术中出血量明显少于对照组,实验组术后留置肾造瘘管时间、并发症发生率、一期结石清除率均优于对照组(P<0.05)。结论斜仰卧低截石位较俯卧位经皮肾镜碎石术能缩短手术时间、减少术中出血量、提高一期结石清除率,治疗复杂肾结石更安全、有效。

Objective To contrast the clinical effects of oblique supine-low litllotomy and prone position in ultrasound guided percutaneous nephrolithotomy(PCNL)for the treatment of complicated renal calculus.Methods From January 2010 to April 2017,108 patients with complicated renal calculus under-went PCNL were divided into the observation group(n=65)and the control group(n=43).The observation group were treated with oblique supine-low litllotomy ultrasound guided PCNL,and the control group were treated with prone position ultrasound guided PCNL.The operative time,mean intraoperative blood loss,duration of hospitalization,renal fistula time,postoperative complications and one-stage stone clearance rate were contrasted in the two groups.Results The operative time,mean intraoperative blood loss,duration of hospitalization,renal fistula time,postoperative complications and one-stage stone clearance rate of the observation group were significantly better than that of the control group(P<0.05).Conclusion Compared with the prone position,the oblique supine-low litllotomy position PCNL can effectively shorten the operative time,reduce blood loss and postoperative complications,and improve its prognosis.PCNLin oblique supine-low litllotomy position is a safe and feasible procedure.