不同麻醉方法下输尿管镜钬激光碎石术治疗输尿管中上段结石的比较

Comparison of Ureteroscopic Holmium Laser Lithotripsy under Different Anesthesia Methods for the Treatment of Upper and Middle Ureteral Calculi

目的为了保证输尿管中上段结石治疗效果,探讨不同麻醉方法下输尿管镜钬激光碎石术疗效差异。方法从2018年2月—2019年2月在医院行输尿管镜钬激光碎石术治疗的输尿管上段结石患者中随机选取80例作为研究对象,并按随机、双盲、对照原则将其平均分组,其中连续予以硬膜外麻醉的40例患者设为对照组,予以腰硬联合麻醉的40例患者设为观察组,对比两组麻醉指标及不良反应发生率差异。结果观察组患者感觉阻滞时间、运动阻滞起效时间、感觉阻滞平面固定时间(4.42±1.28)、(10.68±4.22)、(17.78±2.11)min较对照组(5.66±1.41)、(13.93±5.78)、(20.43±3.10)min明显缩短,差异有统计学意义(P<0.05);观察组麻醉期间不良反应的发生率为5.00%(2/40)较对照组的22.50%(9/40)明显降低,差异有统计学意义(χ^(2)=5.160,P<0.05)。结论将腰硬联合麻醉用于输尿管镜钬激光碎石术治疗输尿管中上段结石中,不仅可以提高麻醉效果,还可以在一定程度上降低不良反应的发生率,增强手术安全性,效果显著,值得应用。

Objective In order to ensure the treatment effect of upper and middle ureteral calculi,to explore the difference of the effect of ureteroscopic holmium laser lithotripsy under different anesthesia methods.Methods From February 2018 to February 2019,Convenience select 80 patients with upper ureteral calculi who underwent ureteroscopic holmium laser lithotripsy in the hospital as the study subjects and divided into groups according to random,double-blind,and controlled principles.Among them,40 patients underwent consecutive epidural anesthesia were set as the control group,and 40 patients underwent combined spinal-epidural anesthesia were set as the observation group.The differences in anesthesia indicators and incidence rates of adverse reactions between the two groups were compared.Results The observation group patients'sensory block time,motor block onset time,sensory block plane fixed time(4.42±1.28)min,(10.68±4.22)min,(17.78±2.11)min compared with the control group(5.66±1.41)min,(13.93±5.78)min,(20.43±3.10)min was significantly shortened,and the difference was statistically significant(P<0.05);the occurrence of adverse reactions in the observation group during anesthesia 5.00%(2/40)was significantly lower than that of 22.50%(9/40)in the control group,the difference was statistically significant(χ^(2)=5.160,P<0.05).Conclusion The use of combined spinal-epidural anesthesia for ureteroscopic holmium laser lithotripsy for the treatment of upper and middle ureteral calculi can not only improve the anesthesia effect,but also reduce the incidence of adverse reactions to a certain extent,and enhance the safety of the operation.The effect is significant and worthwhile application.