自制斜仰卧位体位架在经皮肾碎石取石术中的应用
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摘要
目的探讨自制斜仰卧位手术体位架在经皮肾碎石取石术(percutaneous nephrolithotomy,PCNL)中的临床应用价值。方法 2009年3月~2016年12月在斜仰卧位PCNL术中应用自制手术体位架治疗上尿路结石94例,观察摆放体位前后BP、SpO_2、气道压变化。结果 94例均为手术成功,手术时间30~85 min,(51.5±27.3)min。在摆体位前后BP、SpO_2、全麻下气道压均在正常范围内。结论自制的手术体位架可以满足斜仰卧位PCNL体位的要求,体位状态牢靠且标准化,这种体位下行PCNL生命体征更稳定,安全性更高,值得临床推广应用。
Objective To explore the clinical application of a self-made oblique-supine position equipment for percutaneous nephrolithotomy( PCNL).Methods A total of 94 cases of upper urinary tract calculi were given PCNL under general anesthesia by using a self-made oblique-supine position frame from March 2009 to December 2016.The BP,SpO_2,and airway pressure were observed before and after the position changes.Results The operations were successfully performed in all the 94 cases.The operation time was 30-85 min( mean,51.5 ± 27.3 min).The BP,SpO_2 and airway pressure were within the normal range before and after the position changes.Conclusions The self-made operation position frame can meet the requirements of oblique-supine percutaneous nephrolithotomy surgery.Reliable and standardized position are important for PCNL to maintain stable vital signs.It is worthy of clinical popularization and application.
Objective To explore the clinical application of a self-made oblique-supine position equipment for percutaneous nephrolithotomy( PCNL).Methods A total of 94 cases of upper urinary tract calculi were given PCNL under general anesthesia by using a self-made oblique-supine position frame from March 2009 to December 2016.The BP,SpO_2,and airway pressure were observed before and after the position changes.Results The operations were successfully performed in all the 94 cases.The operation time was 30-85 min( mean,51.5 ± 27.3 min).The BP,SpO_2 and airway pressure were within the normal range before and after the position changes.Conclusions The self-made operation position frame can meet the requirements of oblique-supine percutaneous nephrolithotomy surgery.Reliable and standardized position are important for PCNL to maintain stable vital signs.It is worthy of clinical popularization and application.
引文
1潘铁军,彭健,叶章群,等.腰肋悬空仰卧位体位的建立及在经皮肾镜碎石术中的临床研究.临床外科杂志,2010,18(9):619-620.
2谢圣陶,陈广瑜.斜仰卧截石位经皮肾镜联合输尿管镜处理输尿管上段复杂结石.中国微创外科杂志,2014,14(4):348-369.
3那彦群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南(2011版).北京:人民卫生出版社,2011.256.
4张弋,于澄钒,朱鹤,等.斜仰卧位微创经皮肾镜和输尿管软镜治疗输尿管上段结石的非随机比较研究.中华泌尿外科杂志,2013,34(10):775-778.
5李建华,赵谦,李建兴.斜仰卧位经皮肾镜取石术治疗高危上尿路结石的疗效观察.中华腔镜泌尿外科杂志(电子版),2013,7(3):46-48.
6巩全华,刘士峰,杨景明,等.截石斜45°仰卧位经皮肾镜取石术.中华腔镜泌尿外科杂志(电子版),2013,7(6):26-28.
7齐勇,翁国斌,汤春波,等.斜仰截石位多镜联合一期治疗复杂性肾结石.中国微创外科杂志,2017,17(1):59-61.
8梁阳冰.斜仰卧位联合截石位同时输尿管镜下结合经皮肾镜取石术治疗上下尿路结石的疗效观察.中国实用医药,2013,8(31):93-94.
9陈广社,李锋.输尿管软镜与斜仰卧位微创经皮肾镜治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版),2015,9(5):21-24.
2谢圣陶,陈广瑜.斜仰卧截石位经皮肾镜联合输尿管镜处理输尿管上段复杂结石.中国微创外科杂志,2014,14(4):348-369.
3那彦群,叶章群,孙光.中国泌尿外科疾病诊断治疗指南(2011版).北京:人民卫生出版社,2011.256.
4张弋,于澄钒,朱鹤,等.斜仰卧位微创经皮肾镜和输尿管软镜治疗输尿管上段结石的非随机比较研究.中华泌尿外科杂志,2013,34(10):775-778.
5李建华,赵谦,李建兴.斜仰卧位经皮肾镜取石术治疗高危上尿路结石的疗效观察.中华腔镜泌尿外科杂志(电子版),2013,7(3):46-48.
6巩全华,刘士峰,杨景明,等.截石斜45°仰卧位经皮肾镜取石术.中华腔镜泌尿外科杂志(电子版),2013,7(6):26-28.
7齐勇,翁国斌,汤春波,等.斜仰截石位多镜联合一期治疗复杂性肾结石.中国微创外科杂志,2017,17(1):59-61.
8梁阳冰.斜仰卧位联合截石位同时输尿管镜下结合经皮肾镜取石术治疗上下尿路结石的疗效观察.中国实用医药,2013,8(31):93-94.
9陈广社,李锋.输尿管软镜与斜仰卧位微创经皮肾镜治疗输尿管上段结石的疗效比较.中华腔镜泌尿外科杂志(电子版),2015,9(5):21-24.