ABSTRACT
Objective To investigate the clinical application of different puncture positions in percutaneous nephrolithotomy (PCNL).Methods From February 2015 to March 2017,102 patients with kidney urinary calculi in our hospital were enrolled in the study.According to the selected puncture position,they were divided into prone position (group A,32 cases),lateral decubitus position (group B,37 cases) and half stone oblique supine position (group C,33 cases).The mean arterial pressure (MAP),heart rate (HR) and blood oxygen saturation (SpO2) were observed before placement of 5 min (T0),after placement of 5 min (T1),30 min (T2),and postoperative 5 min (T3),and the time of established passage,the time of operation and the amount of bleeding during operation and so on.Results The MAP in group B and group C at T1 was significantly higher than that in group A (P ＜ 0.05);The HR in Group B and group C at T2 and T3 were significantly lower than those in group A (P ＜ 0.05);The SpO2 in Group B and group C at T1 and T2 were significantly higher than those in group A (P ＜ 0.05);There was no significant difference in the time of establishment passage,the rate of primary clearing stone and the hospital stay in the groups (P ＞0.05);The operation time and intraoperative blood loss in group C were (120.07 ± 20.19) min and (90.01 ±30.11)ml,significantly less than those in group B and group A (P ＜0.05);The operation time and intraoperative blood loss in group B were (140.17 ±20.48) min and (110.04 ±29.82) ml,significantly less than that in group A [(170.02 ± 21.02) min,(164.02 ± 30.12) ml] (P ＜ 0.05);The postural comfort of group C was better than that of group A and group B (P ＜ 0.05);There was no significant difference in the incidence of postoperative complications in the three groups (P ＞ 0.05).Conclusions Half stone oblique supine position in the PCNL application has good effect,which is conducive to improving the patient's tolerance to surgery,shorten the operation time,and it is worth popularizing.