斜卧位与俯卧位B超引导下经皮肾镜碎石术治疗上尿路结石的对比研究

A comparative study of recumbent position vs.prone position in percutaneous nephrolithotripsy

目的:比较斜卧位与俯卧位B超引导下经皮肾镜碎石术治疗上尿路结石的疗效。方法:将722例上尿路结石患者随机分为两组,斜卧位组396例,俯卧位组326例,在B超引导下行经皮肾镜碎石术。记录两组手术时间、术后与术前血红蛋白改变、通道数、发生严重并发症例数、术后大出血例数、术后住院天数、分期手术例数及结石清除率等,进行统计学分析。结果:两组在性别、年龄、结石类型、术前的合并症方面均无统计学意义(P>0.05)。斜卧位组手术时间为(81.0±34.6)min,而俯卧位组为(102.0±41.5)min(P<0.05);斜卧位组的手术前后血红蛋白改变为(-12.3±3.2)g/L,俯卧位组的手术前后血红蛋白改变为(-21.1±3.6)g/L(P<0.05);斜卧位组的结石清除率为93.6%,俯卧位组的结石清除率为89.8%(P<0.05)。术中患者舒适度斜卧位组明显优于俯卧位组。结论:斜卧位经皮肾镜碎石术在手术时间、术中出血量、术后住院天数,结石清除率、患者耐受情况等方面优于俯卧位。

Objective:To compare the clinical effectiveness of recumbent position vs .prone position in percutane-ous nephrolithotripsy.Methods:722 cases of upper urinary tract lithiasis receiving percutaneous nephrolithotripsy were divided into prone position group (n =326)and recumbent position group (n =396).The operation time,oper-ation blood loss,number of channels,operative complications,number of significant renal bleeding cases,hospital stay,number of delayed phase lithotripsy cases,and stone clearance rate were compared between two groups.Re-sults:There was no significant difference in the age,gender and complications between the two groups before sur-gery (P >0.05).The operation time was shorter,the operation blood loss was less,and the stone clearance rate was higher in recumbent position group than in prone position group (P <0.05 for all).Conclusions:The recumbent po-sition is better than prone position in operation time,operation blood loss,hospital stay and stone clearance rate.