改良平卧截石位与俯卧位下经皮肾镜取石术治疗肾结石疗效及预后比较

摘要

目的 比较改良平卧截石位与俯卧位下经皮肾镜取石术治疗肾结石的临床疗效及预后.方法 回顾性分析2014年11月至2016年11月收治的肾结石患者共计96例,将患者随机分为两组,每组各48例,分别采用改良平卧截石位下经皮肾镜取石术治疗肾结石(改良平卧截石位组)和采用俯卧位下经皮肾镜取石术治疗肾结石(俯卧位组).记录两组患者的临床疗效,比较两种不同体位的手术时间、出血量及住院时间,同时观察术后疼痛、发热及清石率情况.结果 改良平卧截石位组的临床总有效率(97.91%)明显高于俯卧位组(79.16%),差异有统计学意义(P<0.05).与俯卧位组相比,改良平卧截石位组患者的手术时间、出血量及住院时间均明显降低,差异统计学意义(P<0.01).改良平卧截石位患者的清石率(87.5%)明显高于俯卧位组(52.0%),术后疼痛率(12.5%)、发热率(10.4%)明显低于俯卧位组(39.5%、37.5%),差异均有统计学意义(P<0.05).结论 与俯卧位下经皮肾镜取石术治疗肾结石相比,改良平卧截石位下经皮肾镜取石术治疗肾结石总有效率和清石率更高,术中出血量更少,住院时间更短,不良反应更少,患者预后更好.%Objective To explore the improvement of recumbent lithotomy position and prone position under the effect of the treatment of renal calculi and compare outcomes of percutaneous nephrolithotomy.Methods 96 cases of patients with kidney stones from November 2014 ~ November 2016 in our hospital, and all of the patients were randomly divided into two groups (48 cases in each group), respectively.This study used the modified supine lithotomy position under percutaneous nephrolithotomy in treatment of renal calculi (modified supine lithotomy position) and the prone position of percutaneous nephrolithotomy in treatment of renal calculi (prone position), respectively.And then the clinical efficacy of the two groups were recorded.Thee operation time, bleeding and hospitalization time, postoperative pain, fever and stone clearance rate of two different position were observed.Results The total efficiency (97.91%) of the modified supine lithotomy position group was significantly higher than that in the prone position group (79.16%), the difference was statistically significant (P<0.05).Compared with the prone position group, the operation time, blood loss and hospitalization time of modified supine lithotomy position group were significantly lower than those of prone position group (P<0.01), and there was significant difference between the two groups.The modified supine lithotomy position had stone clearance rate (87.5%), postoperative pain (12.5%), fever (10.4%), significantly higher than the prone position patients with 52%, 39.5%, 37.5%, the difference was statistically significant (P<0.05).Conclusion Compared with the prone position under percutaneous nephrolithotomy in treatment of renal calculi, modified supine lithotomy position under percutaneous nephrolithotomy in treatment of renal calculi and the total efficiency of stone clearance rate was higher, less intraoperative bleeding, shorter hospital stay, fewer adverse reactions, and patients with a better prognosis.