胡春欢　刘书宇　柴方圆　于生龙

[摘要] 目的 探討全麻与椎管内麻醉对经皮肾镜下肾结石手术影响的差异。 方法 将在我院2015年1月～2016年10月就诊，泌尿外科收治确诊的 220 例肾结石患者随机分为椎麻组与全麻组。收治的 220 例患者入院后均接受常规营养支持、对症治疗和护理，均采用经皮肾镜下肾结石手术。按照随机分配原则，分为椎管内麻醉的椎麻组 120 例，全身麻醉的全麻组 100 例。比较两组的手术时间、手术中的失血量、疼痛评分（VAS）、住院时间和术后并发症的发生率。 结果 椎管内麻醉的椎麻组手术时间、术中出血量、住院时间及术后并发症的发生率均少于全身麻醉的全麻组，两组比较有统计学意义（P<0.05），疼痛 VAS 评分略高于全麻组，但差异无统计学意义（P>0.05）。结论 椎管内麻醉下行经皮肾镜下肾结石手术，可有效减少手术时间和术中出血量，降低术后并发症的发生率，有在临床上普及、推广和使用价值。

[关键词] 全麻；椎管内麻醉；经皮肾镜下肾结石手术

[中图分类号] R614；R692.4 [文献标识码] B [文章编号] 1673-9701（2017）04-0122-03

Analysis of the influence difference bewteen general anesthesia and spinal anesthesia in the kidney stones surgery under percutaneous nephrolithotomy

Hu Chunhuan1 Liu Shuyu2 Chai Fangyuan1 Yu Shenglong1

1.Department of Anesthesia，the Second Affiliated Hospital of Mudanjiang Medical College，Mudanjiang 157000，China；2.Hongqi Hospital Affiliated to Mudanjiang Medical College， Mudanjiang 157011，China

[Abstract] Objective To investigate the influence difference between general anesthesia and spinal anesthesian in the kidney stones surgery under percutaneous nephrolithotomy. Methods 220 cases of kidney stones who were treated in depratment of urology in our hospital from January 2015 to December 2016 were randomly dvided into spinal anesthesia group and general anesthesia group. 220 patients admitted in the hospital were given conventional nutritional support， symptomatic treatment and care， and kidney stones surgery under percutaneous nephrolithotomy. According to the principle of random distribution， the patients were divided into spinal anesthesia group with 120 cases of spinal anesthesia and general anesthesia group with 100 cases of general anesthesia. The operative time， the amount of blood loss during surgery， the pain score（VAS）， the length of hospital stay and the incidence of postoperative complications were compared. Results The operation time， intraoperative blood loss， hospitalization time and the incidence of postoperative complications in spinal group were significantly less than those of general anesthesia group，and the difference was significant（P<0.05）. Pain VAS score in spinal group was slightly higher than that of the general anesthesia group， but the difference was not statistically significant（P>0.05）. Conclusion Percutaneous nephrolithotomy renal calculi surgery under spinal anesthesia can effectively reduce the operation time，intraoperative blood loss and the incidence of postoperative complications， which is worthy of clinical popularity， promotion and use.

[Key words] General anesthesia； Spinal anesthesia； Percutaneous nephrolithotomy renal calculi surgery

随着人们生活的不断进步、工作强度大、运动锻炼少，身体的各个器官都敲响了警钟，尤其现在应酬较多，饮酒和油腻食物在所难免，尿石病呈逐年升高的趋势[1]。尿石病是各种致病因素互相作用之下使泌尿系统的任何部位出现的结石病，肾结石就是发病率相对较高的结石病之一[2]。主要出现深部性的腰部疼痛、肉眼可见血尿、尿痛及感染等不适症状。治疗肾结石的方法有多种，传统的有防石、溶石、排石等治疗方式，但治疗不甚彻底。……