经双镜联合碎石术采取半截石斜侧卧位对肾结石治疗效果的影响分析

Effect of Oblique Lateral Position of Hemilithotomy on the Treatment of Renal Calculi by Double Mirror Combined Lithotripsy

目的分析肾结石经双镜碎石术采取半截石斜侧卧位的效果。方法选取2020年9月—2021年9月在广西中医药大学附属瑞康医院接受经输尿管镜肾镜碎石术的118例肾结石患者进行前瞻性单盲随机法分组研究,对照组采用截石位+俯卧位(59例),研究组采用半截石斜侧卧位(59例),比较两组血流动力学与手术时间、结石清除情况及并发症发生情况。结果安置体位后3 min,研究组舒张压(DBP)、收缩压(SBP)、心率(HR)、呼吸(R)和血氧饱和度(SpO2)波动幅度均低于对照组,差异有统计学意义(P<0.05)。研究组手术时间短于对照组,差异有统计学意义(P<0.05)。两组结石清除率比较,差异无统计学意义(P>0.05);研究组未出现并发症,对照组并发症发生率为10.17%,差异有统计学意义(χ^(2)=4.390,P<0.05)。结论经输尿管镜肾镜碎石术术中保持半截石斜侧卧位对肾结石治疗效果起到重要作用,可缩短患者手术时间,并发症少。

Objective To analyze the effect of oblique lateral decubitus of hemilithotomy by double mirror lithotripsy.Methods 118 patients with renal stones who underwent ureteroscopic nephrolithotripsy at Ruikang Hospital affiliated to Guangxi University of Traditional Chinese Medicine from September 2020 to September 2021 were selected for a prospective single-blind randomized grouping study.The control group used lithotomy+prone position(59 cases),and the study group used hemilithotomy oblique lateral position(59 cases).The hemodynamics,operation time,stone clearance and complications of the two groups were compared.Results Three minutes after placement,the fluctuations of diastolic blood pressure(DBP),systolic blood pressure(SBP),heart rate(HR),respiration(R)and blood oxygen saturation(SpO2)in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).The operation time of the study group was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in stone clearance rate between the two groups(P>0.05).There were no complications in the study group,and the incidence of complications in the control group was 10.17%,the difference was statistically significant(χ^(2)=4.390,P<0.05).Conclusion During ureteroscopic nephrolithotripsy,maintaining the oblique lateral position of hemilithotomy plays an important role in the treatment of renal calculi,which can shorten the operation time of patients with fewer complications.