斜仰截石位与俯卧位行经皮肾镜碎石取石术在肥胖患者中临床研究.docVIP

斜仰截石位与俯卧位行经皮肾镜碎石取石术在肥胖患者中临床研究 　　[摘要]目的 探讨斜仰截石位与俯卧位行经皮肾镜碎石取石术在肥胖患者中的临床效果。方法 选取我院2013年2月～2016年3月收治的肾结石肥胖患者86例为研究对象，随机分为斜仰截石位组和俯卧位组，各43例，分别采用斜仰截石位经皮肾镜碎石取石术与俯卧位经皮肾镜碎石取石术进行治疗，比较两组患者手术持续时间、术中出血量、术后住院时间、一次手术结石除净情况及并发症的发生情况。结果 斜仰截石位组患者手术持续时间、术中出血量、术后住院时间皆明显少于俯卧位组，一次手术结石除净率为90.7%，明显高于俯卧位组的74.4%，并发症总发生率为2.3%，明显低于俯卧位组的13.9%，差异均有统计学意义（P0.05）。结论 斜仰截石位体位下行经皮肾镜碎石取石术在肥胖肾结石患者治疗中，明显缩短了手术时间与术后住院时间、降低了术中出血量、提高了一次手术结石除净率、降低了术后并发症的发生风险，具有更高的临床应用价值。 　　[关键词]斜仰截石位；俯卧位；经皮肾镜碎石取石术；肥胖；临床效果 　　[中图分类号] R692.4 [文献标识码] A [文章编号] 1674-4721（2017）03（a）-0091-03 　　[Abstract]Objective To explore the clinical effects of percutaneous nephrolithotomy（PCNL） for obese patients in prone position and semisupine-lithotomy position.Methods 86 patients with renal calculi in our hospital from February 2013 to March 2016 were selected and randomly divided into semisupine-lithotomy group and prone group，43 cases in each group，they were respectively treated by percutaneous nephrolithotomy in prone and semisupine-lithotomy position.Operative time，volume of blood loss，length of postoperative hospital stay，one-time stone disposable rate and incidence of complications were statistically compared between two groups.Results Operative time，volume of blood loss and length of postoperative hospital stay in semisupine-lithotomy group were significantly less than those in prone group；one-time stone disposable rate of semisupine-lithotomy group was 90.7%，obviously higher than that of prone position group of 74.4%；the incidence of complications was 2.3% in semisupine-lithotomy group，significantly lower than that 13.9% in prone group，the differences were significant（P0.05）.Conclusion PCNL in semisupine-lithotomy position can shorten operative time and postoperative hospital stay，reduce blood loss and postoperative complications，promote one-time stone disposable rate，which has higher value of clinical application for obese patients with renal calculi. 　　[Key words]Semisupine-lithotomy position；Prone position；Percutaneous nephrol