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目的：探讨高龄患者行经皮肾镜碎石术的最佳麻醉方法。方法将56例单侧结石老年人患者按照随机数字表法分成2组：①组，腰硬联合麻醉；②组，全身麻醉。比较两组麻醉镇痛效果、麻醉后不良反应发生及血流动力学波动情况。结果①组的麻醉镇痛满意度92.86%与②组的96.43%比较无显著性差异（>0.05）；①组易出现低血压（5例），②组易出现体温过低且苏醒延迟（4例）；②组截石位、俯卧位时的收缩压、舒张压和心率均明显稳定于①组（<0.05）。结论高龄患者行经皮肾镜碎石术选择腰硬联合麻醉、全麻都能满足麻醉深度，但全麻可使体位变化时的血流动力学更平稳。“,”Objective To investigate the best anesthesia method for elderly patients in percutaneous nephrolithotomy lithotripsy. Methods The 56 cases of of elderly patients with unilateral stones according to the random number table is divided into two groups: group1 was given spinal and epidural anesthesia, and group2 was given general anesthesia. The anesthetic effect, adverse reactions after anesthesia, and the changes of hemodynamic in 2 groups were compared. Results The analgesic satisfaction 92.86%in the group1 were no significant difference than the group2 96.43% ( <0.05);the group1 prone to hypotension (5cases), and the group2 prone to hypothermia and delayed recovery (4cases); the systolic blood pressure, diastolic blood pressure and heart rate when lithotomy position and prone position in the group2 were significantly stable than the group1 ( <0.05). Conclusion There is great anesthetic effect of spinal and epidural anesthesia or general anesthesia for elderly patients in percutaneous nephrolithotomy lithotripsy, and the general anesthesia can stabilize hemodynamics when the position changes.