斜仰卧位与截石位在输尿管软镜吸引取石术中的比较
第23卷 第5期 中国内镜杂志 Vol. 23 No. 5 2017年5月 China Journal of Endoscopy May 2017· 9 ·论 著
收稿日期：2016-07-13
*基金项目：江西省科学技术厅重大科技项目（No ：20152ACG70009）；赣州市科学技术局重大科技项目（No ：赣市财教字[2014]131号）；赣州市科学技术局指导性科技计划项目（No ：GZ2015ZSF182）
[通信作者] 朱伦锋，E-mail ：279971368@https://www.wendangku.net/doc/b5222537.html, ；Tel ：135********
DOI: 10.3969/j.issn.1007-1989.2017.05.003
文章编号： 1007-1989（2017）05-0009-04
斜仰卧位与截石位在输尿管软镜吸引取石术中的比较*
邓小林，宋乐明，彭作锋，钟久庆，黄建荣，朱伦锋
[江西省赣州市人民医院（南昌大学附属赣州医院） 泌尿外科，江西 赣州 341000]
摘要：目的 比较斜仰卧位与截石位在输尿管软镜吸引取石术中应用的安全性及疗效。方法 两组上
尿路结石患者共82例，其中斜仰卧位47例，截石位35例，术前两组患者在年龄、性别和合并症等方面比较，
差异均无统计学意义（P >0.05）
，比较两组患者的手术时间、肾盂内压、术后30天清石率、并发症及住院天数。结果 73例手术一期完成，9例留置DJ 管2周后成功行软镜手术。与截石位相比，斜仰卧位组患者的结
石清除率明显提高，而手术时间明显缩短（P <0.05）
。两组的并发症、肾盂内压和住院天数差异无统计学意义（P >0.05）
。结论 斜仰卧位输尿管软镜吸引取石术与传统体位相比，同样安全且碎石效率更高。关键词： 斜仰卧位；截石位；输尿管软镜
中图分类号： R691.4 文献标识码： A
Suctioning flexible ureteroscopic lithotripsy in the oblique supine position and lithotomy position: a comparative study *
Xiao-lin Deng, Le-ming Song, Zuo-feng Peng, Jiu-qing Zhong, Jian-rong Huang, Lun-feng Zhu
[Department of Urology, the People’s Hospital of Ganzhou (the Affiliated Ganzhou Hospital of Nanchang
University), Ganzhou, Jiangxi 341000, China]
Abstract: Objective To compare the safety and efficacy of oblique supine position and lithotomy position in
suctioning flexible ureteroscopic lithotripsy. Methods 82 patients with upper urinary calculi were divided into two
groups. Group 1 included 47 patients who were treated by suctioning flexible ureteroscopy in oblique supine position.
Group 2 included 35 patients who were treated in lithotomy position. There was no significant statistical difference
in age, gender and complications between the two groups before surgery (P > 0.05). The operative time, stone-free
rates at postoperative 30 d, renal pelvic pressure (RPP), postoperative complications (graded by the Clavien system)
and length of stay were compared. Results Retrograde Intrarenal Surgery (RIRS) was successful in 73 cases, and
9 cases of patients were done successfully after indwelling DJ tube 2 weeks. Compared with lithotomy position, a
significantly greater stone-free rate of 30 d, shorter operative time (P < 0.05). There was no difference in complication
rate of Clavien grade I and Clavien grade II, RPP and length of stay (P > 0.05). Conclusions Suctioning flexible
ureteroscopic lithotripsy in the oblique supine position is safe, and more effective than supine lithotomy position.
Keywords: oblique supine position; lithotomy position; flexible ureteroscope
自MARSHALL [1]1964年首次采用输尿管软镜碎
石术（retrograde intrarenal surgery，RIRS）治疗输尿管
结石以来，到目前已有近50年的历史。近年来，随着新型输尿管镜及相关设备的发展，输尿管软镜技术在上尿路结石治疗方面的应用越来越广泛[2]
。由于输尿管软镜术中肾盂及肾盏是相对封闭的，逆行进入肾盂