摘要
目的比较俯卧位与斜仰卧位对微创经皮肾镜取石术(MPCNL)过程中腹内压力及术中出血量的影响。方法 80例单侧输尿管结石患者随机分为斜仰卧位组(40例)和俯卧位组(40例)。均采用气管插管全身麻醉,分别采用斜仰卧位组和俯卧位,行微创经皮肾镜取石术(MPCNL)。结果均顺利完成手术。斜仰卧位组在手术时间及出血量方面与俯卧位组差异有显著性,俯卧位组摆放体位后及手术结束时的腹内压力及气道阻力明显大于术前(P<0.05),俯卧位组术中出血量与摆放体位后腹内压力有显著相关性;两组均无胸膜损伤、肠损伤及肾周围其他脏器损伤等并发症,无改开放手术者。术后随访1个月,肾积水不同程度减轻,无输尿管狭窄或结石复发。结论采用斜仰卧位行MPCNL,可以降低术中胸腹部受压的几率,减少术中出血量,缩短手术时间。
【Objective】 To compare the influence of internal pressure and bleeding during minimally invasive percutaneous nephrolithotomy（MPCNL） in the prone position and inclined supine position.【Method】 Eighty patients with unilateral ureter stone were divided randomly into two groups,prone position group of 40 cases and inclined supine position group of 40 cases,in the prone position and inclined supine position completed the MPCNL respectively.【Result】 All patients with smooth operation,the operation time and the bleeding had significantly differences between prone position group and inclined supine position group,When after put a position and end of surgery,internal pressure and bleeding significantly greater than preoperative in prone position group,the bleeding and the internal pressure had significant correlation.Both groups without pleural damage,intestinal damage and renal around other organs damage,No case changed to the open surgery.Patients were followed up a month,renal water had reduced for a degree,and no ureteral stricture or recurrence of stones.【Conclusion】 MPCNL in the inclined supine position can reduce chest compression in operation,reduce the chance of perioperative bleeding,shorten the time of the operation.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第3期249-251,共3页
China Journal of Endoscopy
关键词
俯卧位
斜仰卧位
微创经皮肾镜取石术
腹内压
出血量
prone position
inclined supine position
minimally invasive percutaneous nephrolithotomy
internal pressure
blood loss
