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

Comparative study of oblique supine and prone position in ultrasound guided percutaneous nephrolithotomy for the treatment of upper urinary tract calculi

目的 :对比斜卧位与俯卧位B超引导下经皮肾镜碎石术治疗上尿路结石的临床效果。方法 :59例上尿路结石患者随机分为观察组(n=25)与对照组(n=34),观察组给予斜卧位B超引导下经皮肾镜碎石术治疗,对照组给予仰卧位B超引导下经皮肾镜碎石术治疗,对比两组患者临床疗效。结果 :观察组患者重度不适发生率为4.0%,显著低于对照组的29.4%,两组患者轻度不适与中度不适比较差异无统计学意义;观察组通道建立时间、手术时间、术中出血量、肾造瘘管留置时间、术后与术前血红蛋白变化、住院时间、术后感染发生率、结肠损伤发生率、Ⅰ期结石清除率、需Ⅱ期手术例数均显著优于对照组。结论 :斜卧位B超引导下PCNL术可有效增强患者手术耐受力,提高结石清除率,减少术中出血量及术后并发症,更安全,更高效,值得临床推广。

Objective To contrast the clinical effects of oblique supine and prone position in ultrasound guided percutane-ous nephrolithotomy for the treatment of upper urinary tract calculi.Methods59 patients with upper urinary tract calculi were randomly divided into the observation group (n=25) and the control group (n=34), the observation group were treated with ob-lique supine ultrasound guided percutaneous nephrolithotomy, and the control group were treated with prone position ultrasound guided percutaneous nephrolithotomy, then the clinical effects were contrasted between the two groups.Results Severe discom-fort incidence in the observation group was 4.0%, significantly lower than 29.4% in the control group, no significantly difference in mild discomfort and moderate discomfort between the two groups; the channel establishment time, operation time, intraopera-tive bleeding, renal fistula time, hemoglobin changes, duration of hospitalization, the incidence of postoperative infection, the incidence of colon injury, one-stage stone clearance rate, second stage surgical cases in the observation group were significantly better than the control group.Conclusion Ultrasound guided percutaneous nephrolithotomy with oblique supine can effectively enhance the patient's surgical tolerance, improve the stone clearance rate, reduce the amount of bleeding and postoperative complications, it's more safety, more efficient, and worthy of promotion.