【摘要】 目的探讨3种手术体位对经皮肾镜碎石术(PCNL)患者的影响,选择最佳手术体位标准。方法将60例经皮肾镜碎石手术患者,随机分为俯卧位、仰卧位、45°斜仰卧位3组,每组各20例。观察改变不同体位后患者血压、心率及血氧饱和度的变化,同时对3种体位下建立通道时间、手术时间、术中出血量、一次清石率进行对比。结果 3种体位均能顺利完成手术,45°斜仰卧位和仰卧位安置后血压、心率及血氧饱和度较俯卧位更稳定,其手术时间、术中出血量、一次清石率等指标优于俯卧位及仰卧位。结论 45°斜仰卧位经皮肾输尿管镜取石术治疗上尿路结石具有安全、高效、微创的特点,患者体位舒适,便于术中麻醉检测,术中碎石易排出,值得临床推广应用。更多还原

【Abstract】 Objective To explore three kinds of lithotomy positions on patients operated with percutaneous nephrolithotomy lithotripsy(PCNL) and to find out the optimal position.Methods 60 cases of PCNL patients were randomly divided into the prone position,lateral position,and 45° supine anterolateral lithotomy position groups,20 patients in each group,to observe the changes of blood pressure,heart rate and oxygen saturation,and to compare the operation time,blood loss and stone-free rate after one session.Results All operations were successful.The blood pressure,heart rate and oxygen saturation changes were more stable after placement of 45° supine anterolateral or lateral position than prone position.The operation time,blood loss,and stone-free rate after one session by 45° supine anterolateral lithotomy position were significantly advantageous compared with the other body positions.Conclusions PCNL with the patients at semi-supine anterolateral position is safe,effective and minimally invasive for the treatment of upper urinary calculi.The position is helpful to moinitor intraoperative anaesthesia and remove stones.更多还原