截石位联合斜仰卧位在微创经皮肾碎石取石术中的应用效果
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摘要
目的探讨截石位联合斜仰卧位对行微创经皮肾碎石取石术患者的影响观察。方法选取该院2010年5月‐2016年5月收治的100例肾结石患者作为本研究对象,所有患者均行微创经皮肾碎石取石术,对照组患者采用传统俯卧位实施手术,观察组患者采用截石位结合斜仰卧位一体的体位实施手术,分别对两组患者的手术相关指标、术后残石率以及舒适度情况进行客观比较。结果经比较,观察组患者的建立通道时间、手术时间及术中出血量等相关指标明显优于对照组,差异有统计学意义(P<0.05);观察组和对照组相比较,前者术后残石率明显少于对照组(P<0.05);同时,观察组患者手术舒适度情况亦优于对照组(P<0.05)。结论截石位联合斜仰卧位可以辅助提高微创经皮肾碎石取石术的临床疗效,安全性高,且患者体位舒适,有助于术中麻醉检测以及碎石的排出,因而值得临床中推广实施。
【Objective】To study the effect of lithotomy position combined with oblique supine position on patients undergoing minimally invasive percutaneous nephrolithotomy.【Methods】One hundred patients with kidney stones admitted in our hospital between May 2010 and May 2016 were selected as the objects of this study,and all patients were performed minimally invasive percutaneous nephrolithotomy.Patients in the control group were treated by traditional surgery in the prone position,while patients in the observation group were performed surgery by the inclined supine combined with lithotomy position,and indicators related to the operation,postoperative residual stone rate and comfort level between the two groups were compared respectively and objectively.【Results】By comparison,the passage establishment time,operation time,intraoperative blood loss and other related indexes of patients in the observation group were significantly better than those in the control group(P <0.05);the postoperative residual stone rate of the observation group was obviously less than that of the control group(P <0.05);at the same time,the operation comfort level of patients in the observation group was also better than that in the control group(P <0.05).【Conclusion】Lithotomy position combined with oblique supine position can help improve clinical curative effect of the minimally invasive percutaneous nephrolithotomy with high safety and comfortable position,it is help for intraoperative anesthetic detecting and gravel discharge,thus it is worth popularizing in clinical implementation.
【Objective】To study the effect of lithotomy position combined with oblique supine position on patients undergoing minimally invasive percutaneous nephrolithotomy.【Methods】One hundred patients with kidney stones admitted in our hospital between May 2010 and May 2016 were selected as the objects of this study,and all patients were performed minimally invasive percutaneous nephrolithotomy.Patients in the control group were treated by traditional surgery in the prone position,while patients in the observation group were performed surgery by the inclined supine combined with lithotomy position,and indicators related to the operation,postoperative residual stone rate and comfort level between the two groups were compared respectively and objectively.【Results】By comparison,the passage establishment time,operation time,intraoperative blood loss and other related indexes of patients in the observation group were significantly better than those in the control group(P <0.05);the postoperative residual stone rate of the observation group was obviously less than that of the control group(P <0.05);at the same time,the operation comfort level of patients in the observation group was also better than that in the control group(P <0.05).【Conclusion】Lithotomy position combined with oblique supine position can help improve clinical curative effect of the minimally invasive percutaneous nephrolithotomy with high safety and comfortable position,it is help for intraoperative anesthetic detecting and gravel discharge,thus it is worth popularizing in clinical implementation.
引文
[1]程洪林,郭闯,李旭明,等.输尿管镜气压弹道碎石术与微创经皮肾镜取石术治疗输尿管上段嵌顿结石合并感染的对比研究[J].重庆医学,2014(4):442-444.
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[8]郑卓敏,庄泽平,李冕华,等.不同手术体位在老年肥胖患者经皮肾镜取石术中的应用效果观察[J].中国医药科学,2016,6(9):210-213.
[9]张发.不同体位微创经皮肾镜取石术治疗梗阻性结石术中肾盂内压的比较[D].南昌大学医学院南昌大学,2014.
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[11]黄彦,梁业梅.腹型肥胖肾结石患者经皮肾镜碎石术中体位调整的效果观察[J].微创医学,2015,10(4):509-510.
[12]胡晓晖,陈洪波,江克华,等.三种不同体位行微创经皮肾镜钬激光碎石术疗效分析[J].中华腔镜外科杂志电子版,2014(3):55-57.
[13]谢菊芬.两种手术体位用于经皮肾镜钬激光碎石术的效果比较[J].深圳中西医结合杂志,2014,24(1):73-74.
[14]符远迪,郑伟,廖志武,等.微创经皮肾碎石取石术治疗上尿路结石的临床疗效[J].中国社区医师,2016,32(25):60-60,62.
[15]梁小霞,黄海媚,李凤.斜仰卧与截石位一体在经皮肾镜手术中的应用[J].护理实践与研究,2015(1):75-76.
[2]刘成倍,徐伟,廖春华.微创经皮肾镜取石术治疗上尿路结石合并感染的临床研究[J].中华医院感染学杂志,2014,24(1):162-164.
[3]肖春雷,郝一昌.经皮肾镜取石术是处理输尿管镜碎石中结石回移入肾的首选治疗方法[J].现代泌尿外科杂志,2014,19(2):125-127.
[4]周晓波,方友强.体位对经皮肾镜碎石取石术治疗效果和安全性的影响[J].中华腔镜泌尿外科杂志电子版,2016,10(4):26-29.
[5]黄应福,伍伯聪,张文彬.仰斜截石位与常规体位行经皮肾镜取石术186例疗效与安全性比较[J].现代医药卫生,2016,32(6):894-895.
[6]周水根,王玲,徐晓峰,等.改良Valdivia体位和俯卧位经皮肾镜取石术治疗肾结石的疗效和安全性比较[J].中华泌尿外科杂志,2015(6):405-408.
[7]杨利辉,李小兰,朱小冬,等.斜仰卧位与截石位并用的新手术体位安置法对经皮肾镜取石患者安全舒适的影响[J].国际护理学杂志,2014(7):1639-1640.
[8]郑卓敏,庄泽平,李冕华,等.不同手术体位在老年肥胖患者经皮肾镜取石术中的应用效果观察[J].中国医药科学,2016,6(9):210-213.
[9]张发.不同体位微创经皮肾镜取石术治疗梗阻性结石术中肾盂内压的比较[D].南昌大学医学院南昌大学,2014.
[10]张强,张超.俯卧位和斜侧卧位术式经皮肾镜取石术患者中效果比较[J].中国民康医学,2016,28(6):21-23.
[11]黄彦,梁业梅.腹型肥胖肾结石患者经皮肾镜碎石术中体位调整的效果观察[J].微创医学,2015,10(4):509-510.
[12]胡晓晖,陈洪波,江克华,等.三种不同体位行微创经皮肾镜钬激光碎石术疗效分析[J].中华腔镜外科杂志电子版,2014(3):55-57.
[13]谢菊芬.两种手术体位用于经皮肾镜钬激光碎石术的效果比较[J].深圳中西医结合杂志,2014,24(1):73-74.
[14]符远迪,郑伟,廖志武,等.微创经皮肾碎石取石术治疗上尿路结石的临床疗效[J].中国社区医师,2016,32(25):60-60,62.
[15]梁小霞,黄海媚,李凤.斜仰卧与截石位一体在经皮肾镜手术中的应用[J].护理实践与研究,2015(1):75-76.
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