双肾结石俯卧与仰卧位经皮肾镜术的对比研究

目的：探讨俯卧位与仰卧位采取经皮肾镜取石术（percutaneous nephrolithotomy，PCNL）的安全性和疗效比较。方法：对9例双肾结石患者，分别分期行采用B超引导一侧俯卧和另一侧仰卧位PCNL。结果：9例患者18侧肾全部取石成功，其中3例5侧肾行二期取石。俯卧和仰卧位的手术时间、术后住院时间及一次清石率分别为（108．2土45．6）min，（116．5±31．2）min；（5．6±1．8）天，（5．8±1．5）天；66．7％（6／9），77．8％（7／9）。术中血气均无显著变化，未出现严重手术并发症。俯卧位时恶心、呕吐者8例，呼吸困难4例，肩痛5例，术中因不适药物干预7例，其中2例因不能耐受终止手术2例；仰卧位肩痛2例，未出现药物干预和因不能耐受终止手术。结论：PCNL仰卧位较俯卧位患者耐受性好、痛苦小，而两者疗效无差异，是更好的PCNL治疗体位的选择。

Percutaneous Nephrolithotomy in Supine and Pronate Position(Report of 9 Cases)

Objective：To evaluate the technique of PCNL in supine position. Methods：Nine patients with both renal calculi calculi were treated with PCNL,one renal in modified supine position and another one in prone position. Results： All cases were accomplished. 5 cases of complex renal calculi needed 2 procedures. The mean operativetime, the mean hospital stay, clearance rate in supine and pronate position were （108.2 ± 45.6） mins, （116.5 ±31.2） rains; （5.6±1.8） d,（5.8±1.5） d; 66.7% （6/9）,77. 8%（7/9）. No injury complication was observed. The patients feel more comfortable in supine position. Conclusions：The technique of PCNL with the patient in supine position is safe,effective,easy-doing and worth to spread. The supine position is the most comfortable position for patients accepting PCNL.