A Comparative Study Of Respiratory Circulation And Efficacy Of Percutaneous Nephrolithotomy In Modified Lateraland Prone Positions

Objective:By comparing the effect of percutaneous nephrolithotomy in modified lateral decubitus position and prone position on patients’respiratory circulation and the difference of surgical efficacy,the paper provides a theoretical basis for the promotion of percutaneous nephrolithotomy in improved lateral decubitus position.Methods:In this prospective study,108 patients with renal calculi in our hospital were randomly divided into two groups:56 patients underwent percutaneous nephrolithotomy in modified lateral decubitus position,and 52patients underwent percutaneous nephrolithotomy in prone position.Compared two groups of patients in a group of cut stone（T₁）,after the change of position（T₂）,after changing positions after 30 minutes（T₃）and surgery（T₄）finish four period of blood pressure,heart rate,blood oxygen saturation and the airway peak pressure,and compare the two groups in stone clearance,gravel lithotomy time,operation time,postoperative hospital stay,and complications such as differences.Results:1.At T₃and T₄,blood pressure of patients in the modified lateral decubitus position and prone position group was decreased compared with that at T₁（P<0.05）,and the decrease was more obvious in the prone position group（P<0.05）.When the body mass index（BMI）was≥25kg/m²,the blood oxygen saturation in the prone group at T₃and T₄time points was lower than that at T₁（P<0.05）,and the difference was also statistically significant compared with that in the lateral lying group（P<0.05）.2.At the time of T₃,the peak airway pressure in the prone group was significantly higher than that in the supine position（P<0.05）,while the peak airway pressure in the improved lateral position group was slightly decreased（P<0.05）.Compared with the two groups,the airway peak in the modified lateral decubitus position group was lower than that in the prone position group（P<0.05）,and the difference between the two groups was more significant when BMI was≥25kg/m²（P<0.05）.3.Percutaneous nephrolithotomy in the modified lateral decubitus position was lower than that in the prone position group in terms of operation time,lithotripsy time,decreased hemoglobin level and incidence of postoperative complications（P<0.05）,and had a higher stone clearance rate（P<0.05）.Conclusion:1.The influence of modified lateral decubitus percutaneous nephrolithotomy on the respiratory circulation of patients is less than that in the prone position,and the surgical tolerance of patients is increased.It is more suitable for the elderly,obese,patients with previous basic heart and lung diseases or patients with spinal deformity.2.The improved lateral decubitus percutaneous nephrolithotomy has the advantages of high stone clearance rate,less intraoperative bleeding,high lithotripsy removal efficiency and low incidence of surgical complications.It is a safe and effective operation method.3.Percutaneous nephrolithotomy in the modified lateral decubitus position is highly efficient and convenient,so it is recommended as the ideal surgical position for percutaneous nephrolithotomy.