Effects of combined operation with double mirrors in the oblique supine lithotomy position on intraoperative physical sign fluctuations, stone clearance rate and complications in patients with complicated kidney stones
Ding Rui*, Ma Linlin, Li Boke, Huo Zhongchao, Cheng Haifeng
Department of Urology, Handan Central Hospital, Hebei Province, Handan 056001
摘要目的：探讨斜仰卧截石位联合经皮肾镜取石术和输尿管软镜碎石术对复杂性肾结石患者术中体征波动、结石清除率及并发症的影响。方法：回顾性分析2017年6月至2019年10月邯郸市中心医院泌尿外科复杂性肾结石患者100例,根据体位不同分为研究组和对照组,每组50例。研究组行斜仰卧截石位联合经皮肾镜取石术和输尿管软镜碎石术,对照组行经皮肾镜取石术。比较两组术中体征波动[心率（HR）、血氧饱和度（SpO2）、收缩压（SBP）、舒张压（DBP）]指标、手术指标（手术时间、住院时间、结石清除率）及术后并发症发生率。结果：相比对照组,研究组手术30min后和手术结束时HR快[（88.57±6.82） vs. （85.36±6.08）次/min;（90.38±7.28） vs. （87.07±8.54）次/min]、SBP[（124.43±12.21） vs. （129.88±13.16）mmHg;（122.21±12.65） vs. （127.67±11.73）mmHg]和DBP[（75.51±8.81） vs. （80.18±9.04）mmHg;（74.16±8.23） vs. （77.65±8.16）mmHg]低,住院时间短[（6.36±2.07） vs. （7.42±2.24）d],结石清除率高[86%（43/50） vs. 68%（34/50）],差异具有统计学意义（P<0.05）。两组手术时间和并发症差异无统计学意义（P>0.05）。结论：斜仰卧截石位双镜联合手术有利于维持复杂性肾结石患者术中HR、SBP、DBP稳定,缩短住院时间,提高结石清除率,对手术时间和并发症发生率无明显影响。
Abstract：Objective： To investigate the effect of oblique supine lithotomy position combined with percutaneous nephrolithotomy and flexible ureteroscope lithotripsy on intraoperative signs fluctuation, stone clearance rate and complications in patients with complicated renal calculi. Methods： From June 2017 to October 2019, 100 patients with complicated renal calculi in Urology Department of Handan Central Hospital were retrospectively analyzed. They were divided into study group and control group according to body position, with 50 patients in each group. The study group underwent oblique supine lithotomy combined with percutaneous nephrolithotomy and flexible ureteroscopic lithotripsy, and the control group underwent percutaneous nephrolithotomy. The two groups were compared in terms of intraoperative signs fluctuation [heart rate （HR）, oxygen saturation （SpO2）, systolic blood pressure （SBP）, diastolic blood pressure （DBP）], surgical indexes （operation time, hospital stay, stone clearance rate） and postoperative complications. Results： The HR in the study group was faster after 30 min and at the end of the operation [（88.57±6.82） vs. （85.36±6.08） beats/min; （90.38±7.28） vs. （87.07±8.54） beats/min], SBP [（124.43±12.21） vs. （129.88±13.16） mmHg; （122.21±12.65） vs. （127.67±11.73） mmHg] and DBP [（75.51±8.81） vs. （80.18±9.04） mmHg; （74.16±8.23） vs. （77.65±8.16） mmHg] were lower, hospital stay [（6.36±2.07） vs. （7.42±2.24） d] was shorter, and stone clearance rate [86% （43/50） vs. 68% （34/50）] was higher than in the control group, and the difference was statistically significant （P<0.05）. There was no significant difference in operation time and complications between the two groups （P>0.05）. Conclusion： Inclined supine lithotomy position combined with double endoscopy is beneficial to maintain the stability of HR, SBP and DBP in patients with complicated renal calculi, shorten the hospital stay and improve the stone clearance rate, and has no obvious influence on the operation time and complication rate.
丁瑞, 马林林, 李博科, 霍仲超, 程海峰. 斜仰卧截石位双镜联合术对复杂肾结石患者术中体征波动、结石清除率及并发症的影响[J]. 微创泌尿外科杂志, 2022, 11(4): 224-228.
Ding Rui, Ma Linlin, Li Boke, Huo Zhongchao, Cheng Haifeng. Effects of combined operation with double mirrors in the oblique supine lithotomy position on intraoperative physical sign fluctuations, stone clearance rate and complications in patients with complicated kidney stones. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2022, 11(4): 224-228.
