| 摘要: |
| ［摘要］ 目的 探讨微创经皮肾穿刺输尿管镜取石术（MPCNL）的麻醉管理以及不良反应的处理。方法 选择2011-03～2012-04到该院泌尿外科择期行MPCNL的患者98例，对患者的麻醉方式、液体管理、体温保护、不良反应等进行分析。结果 椎管内麻醉和全身麻醉两种麻醉方式均取得满意的镇痛效果，其中6例患者并发不同程度的灌洗液吸收综合征，4例伴有低体温现象，3例并发苏醒延迟，1例发生肾严重出血，其他患者均顺利完成手术。结论 MPCNL应根据患者具体情况选择最佳的麻醉方式和手术体位，术中严密监测生命体征、做好保温措施、缩短手术时间、降低灌注压力、减少灌注液量和创面出血是减少不良反应的关键。 |
| 关键词: 经皮肾镜 微创手术 碎石术 麻醉管理 |
| DOI：10.3969/j.issn.1674-3806.2013.03.24 |
| 分类号:R 614 |
| 基金项目: |
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| Anesthesia management in mini-percutaneous nephrolithotomy |
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LIANG Yan-hong
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Department of Anesthesiology,Guigang North District People’s Hospital, Guangxi 537100,China
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| Abstract: |
| ［Abstract］ Objective To investigate the anesthesia management and treatment of side-effects in mini-percutaneous nephrolithotomy(MPCNL) for ureteric calculi.Methods Ninety-eight patients with ureteral calculi,ASAⅠ～Ⅱ Grade, were treated with MPCNL between March 2011 and April 2012 in our hospital.The data concerning general state of anesthesia methods, irrigation volume, temperature protection,the treatments of all side-effects were reviewed retrospectively.Results Both spinal canal anesthesia and general anesthesia way achieved satisfactory analgesic effect.There were 6 patients complicated by lavage fluid absorption syndrome in varying degree,4 patients had hypothermia phenomenon,3 patients delayed recovery and 1 had serious nephrorrhagia.The others were successful.Conclusion It is necessary to select the best anesthesia method and operative position according to the specific situation of the patients.It is important to rigorously monitor patients’vital signs during operation.And well heat preservation measures, shortening the operation time, lowering perfusion pressure, reducing perfusion fluid volume and reducing bleeding of wounds are the effective ways to decrease the occurrence of side-effect in MPCNL. |
| Key words: Percutaneous nephroscope Minimally invasive surgery Nephrolithotomy Anesthesia management |
