Different influences on patients hemodynamics between the prone position and supine position percutaneous lithotripsy / 中华泌尿外科杂志

ABSTRACT

Objective To compare the clinical characters and hemodynamic data of the prone position and supine position percutaneous nephrolithotomy. Methods Patients with kidney stones in 100 cases were randomly assigned into the supine position group and prone position group.There were 50 cases in each group.The following data were recorded at preoperative,intraoperative,change positionthe blood pressure,heart rate,respiration,saturation of blood oxygen and blood gas analysis results.The VAS score was recorded in patients for postural comfort,dyspnea and pain score. Results The systolic blood pressure in the preoperative,intraoperative,postoperative on supine position and prone position were as follows(137±12),(119±15),(115±17) mm Hg and (137±10),(110±18),(104±16) mmHg.The diastalic blood pressure was as follows( 81 ± 9 ),(74 ± 8 ),(63 ± 14 ) mm Hg and ( 84 ± 8 ),(63 ± 9 ),(60 ± 15) mm Hg.Compared with preoperative,there was a blood pressure decreased in both groups.The blood pH at preoperative,intraoperative,postoperative in supine position and prone position7.4 ± 0,7.3 ± 0,7.3 ± 0 and 7.4 ± 0,7.3 ± 0,7.3 ± 0.The bass excess (BE) of two groups were(2.1 ± 0.5),(-2.7 ±0.5),( -1.5 ±0.5) mmol/L and (3.2 ±0.5),(-3.8 ±0.5),(-2.5 ±0.5) mmol/L.Compared with preoperative data,the pH and BE declined in both groups.The prone position had more pronounced decrease in serum sodium,serum potassium; but with no significant difference.Supine group in postural comfort and breathing difficulties were 1.6 ± 0.4 and 7.1 4± 05,while prone group were 7.5 ± 0.2 and 1.4 ± 0.3.The supine position showed better in postural comfort and breathing difficulties with statistical significance. Conclusions Compared with the prone position,the supine positioned percutaneous nephrolithotomy could have less influence on hemodynamics,blood gas analysis.It could have better postural comfort.