Xia Qiang, Zhao Zhenhua, Li Chengbo, Hao Xiaoqiang, Dun Wenchao
Department of Urology, Wuxi 9th Affiliated Hospital of Soochow University, Wuxi, China,
Department of Urology, Nanfang Medical University Affiliated Jiangmen Hospital, Jiangmen, China.
Urol Int. 2019;103(1):89-94. doi: 10.1159/000499584. Epub 2019 Apr 9.
The oblique-supine position for percutaneous nephrolithotomy (PCNL) has advantages, but the position fixation methods are inadequate. This study aimed to analyze the PCNL outcomes using a patented self-made frame for oblique-supine position.
This was a prospective study of patients scheduled to undergo PCNL at 2 hospitals in China between November 2009 and December 2016. The patients underwent PCNL in the oblique-supine position using the self-made position frame (n = 94). Operative time, stone clearance rate, intraoperative average systolic pressure, intraoperative average heart rate, intraoperative average airway pressure, intraoperative average intrapelvic pressure, and complications were observed.
The patients were 45.3 ± 19.7 years old and 71% were male. Stones were of the size 2.5 ± 1.1 cm. The operative time was 95.6 min and the stone clearance rate was 81.9%. Intraoperative systolic blood pressure was 15.13 ± 1.68 kPa. Intraoperative airway pressure was 15.5 ± 2.3 cm H2O. Postoperative fever was observed in 3.2% of the patients. None had organ injury. Postoperative stay was 4.8 ± 0.6 days. The nephrostomy tube was routinely removed on the 5th day after surgery and the patients were discharged on the following day.
The self-made surgical position frame met the position requirements for the oblique-supine PCNL operation. This surgical position frame deserves clinical application and promotion.
经皮肾镜取石术（PCNL）的斜仰卧位具有优势，但体位固定方法存在不足。本研究旨在分析使用专利自制框架进行斜仰卧位PCNL的手术效果。
这是一项对2009年11月至2016年12月在中国两家医院计划接受PCNL的患者进行的前瞻性研究。患者使用自制体位框架在斜仰卧位下行PCNL（n = 94）。观察手术时间、结石清除率、术中平均收缩压、术中平均心率、术中平均气道压力、术中平均肾盂内压力及并发症。
患者年龄为45.3±19.7岁，71%为男性。结石大小为2.5±1.1 cm。手术时间为95.6分钟，结石清除率为81.9%。术中收缩压为15.13±1.68 kPa。术中气道压力为15.5±2.3 cmH₂O。3.2%的患者术后发热。无器官损伤。术后住院时间为4.8±0.6天。术后第5天常规拔除肾造瘘管，次日出院。
自制手术体位框架满足斜仰卧位PCNL手术的体位要求。该手术体位框架值得临床应用与推广。
