CAJ | 학술논문

目的回顾性分析改良平卧截石位与俯卧位下经皮肾镜术治疗肾结石对患者血流动力学的影响.方法回顾性分析遵义医学院附属医院泌尿外科2010年9月至2012年4月采用经皮肾镜术治疗的99例患者的临床资料 ,其中改良平卧截石位44例 ,俯卧位55例.记录并比较两组患者的结石大小、积水程度、体重指数、手术前后8个时间段的血压、心率、氧饱和度等指标 ,统计分析使用 t检验和卡方检验 ,P<0 .05为具有统计学意义.结果在术前对两组患者的年龄、结石大小、肾脏积水程度、体重指数等进行比较 ,差异无统计学意义(P>0 .05) ,具有可比性.两组患者分别在手术前后8个时间段的血压、心率、氧饱和度等比较 ,差异无统计学意义(P>0 .05).结论改良平卧截石位下行PCNL相比传统俯卧位 ,对血流动力学的影响并无潜在优势 ,但具有手术的同时可行输尿管操作的潜在优势 ,仅需摆放一种体位 ,有利于术中麻醉的监测和管理 ,患者更舒适 ,有望成为本术式的一种理想的手术体位.
목적 회고성분석개량평와절석위여부와위하경피신경술치료신결석대환자혈류동역학적영향.방법 회고성분석준의의학원부속의원비뇨외과2010년9월지2012년4월채용경피신경술치료적99례환자적림상자료 ,기중개량평와절석위44례 ,부와위55례.기록병비교량조환자적결석대소、적수정도、체중지수、수술전후8개시간단적혈압、심솔、양포화도등지표 ,통계분석사용 t검험화잡방검험 ,P<0 .05위구유통계학의의.결과 재술전대량조환자적년령、결석대소、신장적수정도、체중지수등진행비교 ,차이무통계학의의(P>0 .05) ,구유가비성.량조환자분별재수술전후8개시간단적혈압、심솔、양포화도등비교 ,차이무통계학의의(P>0 .05).결론 개량평와절석위하행PCNL상비전통부와위 ,대혈류동역학적영향병무잠재우세 ,단구유수술적동시가행수뇨관조작적잠재우세 ,부수파방일충체위 ,유리우술중마취적감측화관리 ,환자경서괄 ,유망성위본술식적일충이상적수술체위.
Objective To retrospectively evaluate the effects of hemodynamics of percutaneous nephrolithotomy (PCNL) in modified supine-lithotomy position and prone position in kidney calcium .Methods A total of 99 patients who underwent PCNL during Sep .2010 and Apr .2012 were divided into two groups:44 patients who took modified supine-lithotomy position and 55 patients who took prone position .The stone size ,hydronephrosis ,and body mass index (BMI) ,blood pressure (systol-ic/diastolic) ,heart rate ,blood oxygen saturation before and after change of position during the operation were recorded and compared ,and analyzed using t-test and chi-square .Results There were no differences in the indexes between the two groups ( P>0 .05) .Conclusions PCNL in modified supine-lithotomy position has no potential advantages compared with the prone position ,but offers the potential advantages of better urethral access ,better monitoring of the anesthesia during proce-dures ,thus reducing overall operation time and offering more comfort for patients .