刘锡海 陈敏坚 刘鸿翔 吴炳权 谢兴年

[摘要]目的探討斜卧截石位在经皮肾镜碎石取石术中的应用及对预后的影响。方法选取2018年5月至2021年5月广东省肇庆市第一人民医院收治的70例经皮肾镜碎石取石术患者作为研究对象，随机分为试验组与对照组，每组各35例。对照组手术时采用常规俯卧位，试验组手术时采用斜卧截石位。比较两组碎石成功率、手术指标、心率、收缩压及预后效果。结果试验组患者的碎石成功率高于对照组，差异有统计学意义（P<0.05）;试验组患者安置体位时间、手术时长短于对照组，差异有统计学意义（ P <0.05）;两组安置后心率高于安置前，收缩压均明显降低，试验组患者心率低于对照组，收缩压高于对照组，差异有统计学意义（ P <0.05）;试验组术后视觉模拟评分法（VAS）评分低于对照组，住院时间明显短于对照组，差异有统计学意义（ P <0.05）。结论在经皮肾镜碎石取石术中使用斜卧截石位可有效提高碎石成功率，改善手术指标，降低心率及血压波动幅度，提高患者预后效果。

[关键词]斜卧截石位;经皮肾镜碎石取石术;肾结石;预后;住院时间

[中图分类号] R699.2  [文献标识码] A   [文章编号]2095-0616（2022）09-0184-04

Application of oblique lying lithotomy position in percutaneous nephrolithotomy and its effect on prognosis

LIU  Xihai    CHEN  Minjian    LIU  Hongxiang    WU  Bingquan    XIE  Xingnian

Department of Urology， First People's Hospital of Zhaoqing City， Guangdong， Zhaoqing 526060， China

[Abstract] Objective To investigate the application of oblique lithotomy position in percutaneous nephrolithotomy and its effect on prognosis. Methods A total of 70 cases of percutaneous nephrolithotomy patients who were admitted in the First People's Hospital of Zhaoqing City， Guangdong Province from May 2018 to May 2021 were selected as the research objects. According to random method， they are divided into the test group and the control group， each group 35 cases each. The control group was used the conventional prone position during the operation， and the test group was used the oblique lithotomy position during the operation. The success rate of lithotripsy， surgical indicators， heart rate， systolic blood pressure and prognostic effects were compared between the two groups. Results The success rate of lithotripsy of the experimental group was higher than that of the control group， and the difference was statistically significant （P <0.05）; The placement time and operation duration of the experimental group were shorter than those of the control group， and the difference was statistically significant （P <0.05）; After placement， the heart rate of the group was higher than before placement， and the systolic blood pressure was significantly reduced， the heart rate of the experimental group was lower than that of the control group， and the systolic blood pressure was higher than that of the control group， the difference was statistically significant （P <0.05）; The VAS score was lower than that of the control group， and the hospital stay was significantly shorter than that of the control group， the difference was statistically significant （P <0.05）. Conclusion The use of oblique lying lithotomy position in percutaneous nephrolithotomy can effectively increase the success rate of lithotripsy， improve the surgical indicators， reduce the fluctuation range of heart rate and blood pressure， and improve the prognosis of patients.

[Key words] Oblique lithotomy position; Percutaneous nephrolithotripsy; Kidney stones; Prognosis; Length of time

肾结石是临床常见的泌尿系统疾病，主要由尿液内草酸、尿酸等物质结晶沉积于肾脏，进而形成肾结石[1]。该病多见于男性，发病时主要症状为疼痛、血尿、排尿困难、尿液浑浊等，若不及时进行治疗，可能引发患者泌尿系统感染或永久性肾损伤[2]。临床上常使用经皮肾镜碎石取石术治疗肾结石，此方法对患者机体损伤较小，且结石清除率高，手术时多采用俯卧位，但该体位不适用于体型肥胖或心肺功能不佳的患者[3]。……