俯卧位下硬膜外腔给药在经皮肾碎石术中的临床应用

Epidural administration under prone position in percutaneous nephrolithotripsy operation

目的:探讨俯卧位下硬膜外腔给药在经皮肾碎石手术当中的临床应用价值。方法:2012年8月-2014年8月收治进行PCNL(经皮肾镜钬激光碎石术)患者160例,所有患者采取俯卧体位下硬膜外腔给药,对其临床麻醉效果给予分析研究。结果:本文160例患者全部对镇痛效果感到满意,没有1例患者由于临床手术操作而主诉疼痛。另外,体位变动以后血压以及心率没有明显变化,和进入手术室以后的血压以及心率之间差异不具有统计学意义(P>0.05),可是在临床操作时间>3 h以后,有7例患者出现全身乏力以及躁动现象,通过对症处理以后手术继续进行。结论:在经皮肾碎石手术当中采取俯卧位下硬膜外腔给药,可以取得显著的临床麻醉效果,不良反应少,具有临床推广价值。

Objective:To investigate the value of application epidural administration under the prone position in percutaneous nephrolithotripsy operation.Methods:160 patients with PCNL(percutaneous nephrolithotomy holmium laser lithotripsy) were selected from August 2012 to August 2014.All the patients took epidural administration under prone position,and then we analyzed the clinical effect of anesthesia.Results:All of those 160 cases were satisfied for the analgesic effect,none of them complained pain during the operation.In addition,their blood pressure and heart rate had no significantly change as the posture changed,and there were no statisticaly significant differences in blood pressure and heart rate after entering operation room(P＞0.05),but when the clinical operation time longer than 3 h,there were 7 patients presented with malaise and restlessness,and they continued the operation after taken symptomatic treatment.Conclusion:Epidural administration under operation position in percutaneous nephrolithotripsy operation can achieve significant clinical anesthetic effect,and also has less adverse reactions,so it is worthy of clinical application.