中国现代医生
中國現代醫生
중국현대의생
CHINA MODERN DOCTOR
2015年
22期
20-22,26
,共4页
经皮肾镜%腰麻%全麻%肾结石
經皮腎鏡%腰痳%全痳%腎結石
경피신경%요마%전마%신결석
Percutaneous nephrolithotomy%SA%GA%Kidney stones
目的：比较腰麻或全麻对经皮肾镜手术治疗肾结石的影响。方法回顾性分析我院2010年6月~2014年9月收治的60例经皮肾镜治疗的肾结石患者,将其随机分为两组院30例患者在腰麻下手术,患者鞘内0.5豫布比卡因15~20 mg和0.01~0.02 mg咪达唑仑；30例患者在全麻下手术,患者予1~2μg/kg芬太尼和0.01~0.02 mg/kg咪达唑仑和静脉注射100μg/(kg·min)异丙酚和0.5 mg/kg阿曲库铵。连续监测两组患者收缩压、舒张压、脉率,记录各组数据,并且比较患者手术时间、麻醉时间、恢复时间、失血量、收缩压、舒张压、脉率变化。结果腰麻组患者的麻醉前平均血压和脉率与术中90 min血压和脉率比较,差异无统计学意义(P>0.05)；全麻组患者的麻醉前平均血压与术中90 min血压比较,差异有统计学意义(P<0.05)。手术时间、麻醉时间及失血量在全麻组和腰麻组分别为(112.2±18.3)vs (99.3±21.1)min,(112.2±18.3)vs (101.3±22.0)min,(331.7±151.1) vs (211.0±89.6)mL,全麻组明显高于腰麻组(P<0.05)。结论经皮肾镜手术在腰麻过程中血流动力学稳定,而且失血量少,手术时间和麻醉时间短,值得临床应用。
目的：比較腰痳或全痳對經皮腎鏡手術治療腎結石的影響。方法迴顧性分析我院2010年6月~2014年9月收治的60例經皮腎鏡治療的腎結石患者,將其隨機分為兩組院30例患者在腰痳下手術,患者鞘內0.5豫佈比卡因15~20 mg和0.01~0.02 mg咪達唑崙；30例患者在全痳下手術,患者予1~2μg/kg芬太尼和0.01~0.02 mg/kg咪達唑崙和靜脈註射100μg/(kg·min)異丙酚和0.5 mg/kg阿麯庫銨。連續鑑測兩組患者收縮壓、舒張壓、脈率,記錄各組數據,併且比較患者手術時間、痳醉時間、恢複時間、失血量、收縮壓、舒張壓、脈率變化。結果腰痳組患者的痳醉前平均血壓和脈率與術中90 min血壓和脈率比較,差異無統計學意義(P>0.05)；全痳組患者的痳醉前平均血壓與術中90 min血壓比較,差異有統計學意義(P<0.05)。手術時間、痳醉時間及失血量在全痳組和腰痳組分彆為(112.2±18.3)vs (99.3±21.1)min,(112.2±18.3)vs (101.3±22.0)min,(331.7±151.1) vs (211.0±89.6)mL,全痳組明顯高于腰痳組(P<0.05)。結論經皮腎鏡手術在腰痳過程中血流動力學穩定,而且失血量少,手術時間和痳醉時間短,值得臨床應用。
목적：비교요마혹전마대경피신경수술치료신결석적영향。방법회고성분석아원2010년6월~2014년9월수치적60례경피신경치료적신결석환자,장기수궤분위량조원30례환자재요마하수술,환자초내0.5예포비잡인15~20 mg화0.01~0.02 mg미체서륜；30례환자재전마하수술,환자여1~2μg/kg분태니화0.01~0.02 mg/kg미체서륜화정맥주사100μg/(kg·min)이병분화0.5 mg/kg아곡고안。련속감측량조환자수축압、서장압、맥솔,기록각조수거,병차비교환자수술시간、마취시간、회복시간、실혈량、수축압、서장압、맥솔변화。결과요마조환자적마취전평균혈압화맥솔여술중90 min혈압화맥솔비교,차이무통계학의의(P>0.05)；전마조환자적마취전평균혈압여술중90 min혈압비교,차이유통계학의의(P<0.05)。수술시간、마취시간급실혈량재전마조화요마조분별위(112.2±18.3)vs (99.3±21.1)min,(112.2±18.3)vs (101.3±22.0)min,(331.7±151.1) vs (211.0±89.6)mL,전마조명현고우요마조(P<0.05)。결론경피신경수술재요마과정중혈류동역학은정,이차실혈량소,수술시간화마취시간단,치득림상응용。
Objective To compare the influences of lumbar anesthesia and general anesthesia on the percutaneous nephroscopic surgical treatment of kidney stones. Methods Sixty patients with kidney stones who received percutaneous nephroscopic treatment in our hospital from June 2010 to September 2014 were analyzed retrospectively and randomly divided into two groups. Thirty patients received surgery under lumbar anesthesia with the intrathecal administration of 15-20 mg of 0.5% bupivacaine and 0.01-0.02 mg of midazolam; Thirty patients received surgery under general anes-thesia with the intrathecal administration of 1-2 μg/kg of fentanyl and 0.01-0.02 mg/kg of midazolam and the intra-venous injection of 100 μg/(kg·min) of propofol and 0.5 mg/kg of atracurium. The systolic blood pressure, diastolic blood pressure and pulse rates of the two groups of patients were monitored continuously and each group of data were recorded. And the patients' operative time, anesthesia time, recovery time, blood loss and changes in systolic blood pressure, diastolic blood pressure and pulse rates were compared. Results In the lumbar anesthesia group, the patients' preoperative mean blood pressure and pulse rate compared with the intraoperative 90-minute blood pressure and pulse rate, with no statistically significant differences (P>0.05). In the general anesthesia group, the patients' preoperative mean blood pressure compared with the intraoperative 90-minute blood pressure, with statistically significant differences (P<0.05). The operative time, anesthesia time and blood loss in the general anesthesia group and the lumbar anesthesia group were(112.2±18.3) vs (99.3±21.1) minutes, (112.2±18.3) vs (101.3±22.0) mintues, and (331.7±151.1) vs (211.0±89.6) mL respectively, with the general anesthesia group were significantly higher than the lumbar anesthesia group (P<0.05). Conclusion In the process of lumbar anesthesia, percutaneous nephroscopic surgery enables stable hemodynamics, causes less blood loss and consumes shorter surgical and anesthesia time, thereby worthy of clinical application.
