Comparative Study Of Half Stone Oblique Supine And Prone Position Percutaneous Nephrolithotomy Surgery

Background:Urinary calculi is a common clinical disease,it is a high incidence of urological diseases.Data show that:the occurrence of urinary tract stones rate of 1%-5%annual incidence rate of 0.04%-0.30%,and mostly occurs in middle age,and the treatment has a certain challenge.More traditional methods to open surgical treatment,with the development of minimally invasive techniques urinary system,urinary stones also transition from traditional technology to micro laparoscopic surgery.Percutaneous nephrolithotomy surgery(percutaneous nephroluthotomy,PCNL)in recent years,emerging as a treatment method,which is the use of special Endoscopic lithotripsy and stone extraction device utilizes percutaneous nephrostomy mouth to complete,improve clinical effect.However,the choice of remaining in the position more controversial when patients with clinical percutaneous nephrolithotomy surgery.Classic prone position during surgery likely to cause patient discomfort,decreased tolerance,hemodynamic changes in the body and a series of complications,increased intraoperative anesthetic management difficult.Related scholars Show:supine oblique half stone in B-guided PCNL surgery can get a good effect,but that conclusion has not yet been confirmed.Objective:To study the half stone oblique supine and prone position in classic B-guided percutaneous nephrolithotomy surgery results contrast observation,provide the basis for clinical practice.Methods:February 2014-60 patients data urinary calculi in February 2016 to study the hospital for treatment,the patients were pre-selected B super,KUB + IVP or retrograde angiography,CT imaging technology to determine the location of stones,size,patients underwent percutaneous nephrolithotomy surgery,according to the treatment group of 30 patients were divided into control and observation group of 30 cases.The control group during surgery prone position with the classic posture,the observation group surgery using half stone oblique supine position,collecting data using SPSS 18.0 for statistical analysis,were observed operation time,preparation time position,patient comfort(such as:Have chest tightness,nausea,vomiting),postural complications(such as:pressure ulcer surgery,neuromuscular losses)and other indicators.Results:The two groups TO moment index difference MAP,HR,SP02 and so was not statistically significant(P>0.05);the observation group T1,T2 and T3MAP index was significantly higher(P<0.05);the observation group T1 time HR,SP02 compared with TO and control group was significantly higher(P<0.05);the observation group T2,T3 time HR,SP02 index was significantly lower than the control group(P<0.05);two groups of patients to establish the channel time,blood loss was no significant difference(P>0.05);the observation group surgery time was significantly shorter than the control group(P<0.05);observation group of patients with mild discomfort rate was significantly higher(P<0.05);the observation group to moderate discomfort,severe discomfort rate was significantly lower than the control group(P<0.05);observation group complication rate was 16.67%,significantly lower than the 33.33%in the control group(P<0.05).Conclusion:half stone oblique supine underwent surgery over percutaneous nephrolithotomy effect,not only able to put the position,prepped and draped once completed,to reduce the workload of medical staff,reducing the impact on the patient's respiratory cycle creates the position,which will help stones out,shorten the operation time,surgery can improve patient tolerance to reduce the risk of intraoperative and perioperative morbidity,improve the success rate,should be widely applied.