灌注液温度对微创经皮肾穿刺取石术患者生理指标的影响

Study of the effects on patients' biological indexes with perfusion liquid at various temperatures during the minimally invasive percutaneous nephrolithotomy

目的:探讨不同温度灌注液对微创经皮肾穿刺取石术患者的影响,以选择该手术较适宜的灌注液温度。方法:选择硬脊膜外麻醉下行微创经皮肾穿刺取石术患者90例,随机分为三组,灌注液加温至(35±1)℃为A组,(29±1)℃为B组,(23±1)℃为C组,观察三组患者围手术期的血压、心率、体温、失血量、寒战和躁动发生率、血小板计数等。结果:A组患者围手术期的血压、心率、体温等组内比较差异无显著性意义(P(0.05);B组患者围手术期血压组内比较差异无显著性意义(P(0.05),心率、体温变化组内比较有差异(P(0.05);C组患者围手术期的血压、心率、体温等组内比较有差异(P(0.05);三组患者手术中、手术后的血压、心率、体温、术中失血量等组间比较,除A组与B组术后体温、术中失血量、术中血小板计数比较,差异无显著性意义外(P(0.05),其余有差异(P(0.05);三组术中寒战和躁动发生率有差异(P(0.05)。结论:灌注液加温至29～35℃,可以使患者在围手术期的血压、心率平稳,失血量减少,体温下降幅度减少,保持患者的正常体温,降低术中寒战和躁动发生率,减少手术并发症。

Objective：To study the effects of perfusion liquid at various temperatures on Minimally Invasive Percutaneous Nephrolithotomy（MPCNL）patients,then find out the appropriate for the operation.Methods：We chose 90 cases of MPCNL patients who undertake the epidural anesthesia.We divide these patients into 3 groups randomly,Group A in which the perfusion liquid at（35±1）℃ was applied to the patients,Group B at（29±1）℃,and Group C at（23±1）℃,then observed the parameters including：blood pressure,heart rate,body temperature,blood loss,shiver and platelet count during perioperative period.Results：During the perioperative period,the in Group A,no significant difference was observed in terms of all parameters（P 〉0.05）;in Group B,heart rate and body temperature varied（P〈0.05）,but no significant was observed in blood pressure（P〉0.05）;in Group C,the blood pressure,heart rate and body temperature vary（P〈0.05）.Among 3 groups of patients,by comparing their blood pressure,heart rate,temperature and blood loss at in-operation and post-operation,no significant difference was found in terms of temperature,blood lost and platelet count between Group A and B（P〉0.05）,apart from that,differences were found in all other parameters（P〈0.05）,and the rate of shiver occurring was different in 3 groups（P〈0.05）.Conclusion：That heating the perfusion liquid to a temperature at a range of 29~35 ℃ helps to maintain the stability of heart rate and blood pressure,reduce the extend of blood loss and temperature drop,and low down the rate of shiver occurring,and finally diminish the postoperative complications.