不同麻醉方式对输尿管镜置镜效果的影响

目的 评估不同麻醉方式对输尿管镜置镜效果的影响。方法 选取2018 年9 月至2021 年3 月期间收治的95 例输尿管结石患者为研究对象,均行输尿管镜钬激光碎石术,根据所应用的麻醉方式,将患者分为三组：全凭静脉麻醉组（全麻组）33 例,腰麻组31 例,硬膜外麻组31 例。记录并分析三组患者输尿管碎石通道建立时间、碎石时间、结石清除率、并发症发生率。结果 全麻组的碎石通道建立时间为（185.99±52.17）s,明显低于腰麻组的（308.06±98.25）s 和硬膜外麻组的（358.22±115.58）s（P<0.01）;全麻组的术中并发症发生率（6.1%）明显低于腰麻组（25.8%）和硬膜外麻组（29.0%）（P<0.05）;三组的碎石时间、结石清除率和术后并发症发生率比较,差异均无统计学意义（P>0.05）。结论 全麻可以缩短输尿管镜钬激光碎石术中的输尿管碎石通道建立时间,减少术中并发症发生率,值得临床推广。

Influences of different anesthesia methods on effect of ureteroscope placement

Objective To evaluate the influences of different anesthesia methods on the effect of ureteroscope placement.Methods A total of 95 patients with ureteral calculi admitted to our hospital from September 2018 to March 2021 were selected.All patients were given ureteroscopic holmium laser lithotripsy.According to anesthesia methods applied,they were divided into three groups,the intravenous anesthesia group (general anesthesia group) with 33 patients,the spinal anesthesia group with 31 patients,and the epidural anesthesia group with 31 patients.The establishment time of ureteral lithotripsy channel,lithotripsy time,stone clearance rate,and incidence of complications in the three groups were recorded and analyzed.Results The establishment time of lithotripsy channel in the general anesthesia group (185.99±52.17)s was significantly shaner than those in the spinal anesthesia group (308.06±98.25)s and the epidural anesthesia group (358.22±115.58)s (P<0.01).The incidence of intraoperative complications in the general anesthesia group (6.1%)was significantly lower than those in the spinal anesthesia group (25.8%) and the epidural anesthesia group (29.0%)(P<0.05).There was no statistically significant differences in lithotripsy time,stone clearance rate,and incidence of postoperative complications among the three groups (P>0.05).Conclusion General anesthesia can shorten the establishment time of ureteral lithotripsy during ureteroscopic holmium laser lithotripsy and reduce the incidence of intraoperative complications.It is worthy of clinical promotion.