半截石卧位和俯卧位经皮肾镜取石术的疗效比较.pdf

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1、微创医学2014年第9卷第l期JournalofMinimallyInvasiveMedicine，2014，9(1)·79·半截石卧位和俯卧位经皮肾镜取石术的疗效比较容祖益蓝志相梁建波韦金鸾(1广西医科大学研究生学院，南宁市530021；2广西壮族自治区人民医院泌尿外科，南宁市530021)【摘要】目的比较半截石卧位和俯卧位经皮肾镜取石术的疗效和安全性。方法将68例肾结石或(并)输尿管上段结石患者随机分成2组，分别在半截石卧位(33例)和俯卧位(35例)实施经皮肾镜取石术，对2组病例的术中出血量、手术时间、工作通道数、I

2、期结石清除率、住院时间、手术并发症等进行比较。结果68例手术均获成功，无穿刺失败和中转开放手术者，无肠管损伤、气胸、大出血等严重并发症。半截石卧位、俯卧位手术时间分别是(73．6±27．5)min及(98．5±30．8)m_in，差异有统计学意义(P<0．05)；而在手术出血量、工作通道、I期结石清除率、术后肾造瘘管留置时间、住院时间、并发症等方面比较差异无统计学意义(P>0．05)。结论半截石卧位施行经皮肾镜取石术具有高效、安全、体位舒适、灵活性强、省时等优点，有良好的推广前景。【关键词】体位；肾结石；经皮肾镜碎石术；输

3、尿管上段结石【中图分类号】R692．4；R693．4【文献标识码】A【文章编号】167345575(2014)01-0079-03DOI：10．11864／j．issn．1673．2014．01．26Comparisonofcurativeefectofsemi-lithotomicsupinepositionwithpronepositioninpercutaneousnephrolithotomyRONGz’，ⅣZhixiang，LIANGJianbo，WEIJinluan(1InstituteofGraduate，G

4、uangxiMedicalUn&e~ity，Nanning530021；2DepartmentofUrology，thePeoplesHospitalofGuangxiZhuangAutonomousRegiOn，Nanning530021，P．R．China)【Abstract】ObjectiveTocomparetheeficacyandsafetyofsemi—lithotomicsupinepositionwithpronepositioninpercutaneousnephrolithotomy(PCNL)．Me

5、thodsSixty—eightcasesofrenalstonesor(and)upperureteralstonesscheduledtoundergoNLweredividedintosemi—lithotomicsupinepositiongroup(n=33)orpronepositiongroup(n=35)randomly．Operationbloodloss，andoperationtime，orkingchannel，stoneclearanceonstageI，staytimeofhospital，op

6、erativecomplicationwerecomparedbetweenthetwogroups．ResultsPCNLwerecompletedsuccessfullyin68patients，withnoseriouspostoperativecomplicationssuchasintestinalinjury，pneumothorax，ormassivehaemorrhageoccurred．Averageoperationdurationwas(73．6±27．5)minforthesemi—lithotom

7、icsupinepositiongroup，and(98．5±30．8)minforthepronepositiongroup，withasignificantdiferencebetweenthetwogroups．Therewasnosignificantdifferenceintheoperationbloodloss，workingchannel，stoneclearanceonstageI，postoperativerenalfistulaindwellingtime，staytimeofhospital，oro

8、perativecomplicationsbetweenthetwogroups(P>0．05)．ConclusionThesemi—lithotomiesupinepositioninPCNLissafe，effective，comfortable，flexible，andtimesaving，and