不同温度冲洗液对微创经皮肾镜取石术老年病人体温影响的研究

Study on the effect of body temperature for elderly patients with minimal invasive percutaneous nephrolithotomy washed at different temperatures

目的观察冲洗液温度对微创经皮肾镜取石术(mPCN)老年病人的体温、脉搏及血压等生命体征的影响。方法将60例老年mPCN患者随机分为加温组30例,mPCN手术时采用36～37℃的加温冲洗液,室温组30例采用20～24℃的室温冲洗液。观察采用不同温度的灌洗液进行手术时,患者的体温、心率及血压的变化。结果加温组手术结束时体温(36.17±0.40)℃,寒战发生率为6.7%;室温组术后体温为(35.31±0.22)℃,寒战发生率为30%。加温组平均动脉压升高和心率加快等改变明显低于室温组。经统计学分析两组间差异有显著意义。结论mPCNL采用室温冲洗液可引起患者低体温,对心率、血压等生命体征有较大的影响。采用加温冲洗液可以明显降低对患者体温、脉搏、血压等的不利影响,有效减少术后高热、寒战及心血管意外等不良事件的发生率。

Objective To observe the effect on body temperature, pulse, blood pressure and other vital signs for elder patients with minimal invasive percutaneous nephrolithotomy washed at different temperature. Method 60 eases of senile patients with minimal invasive percutaneous nephrolithotomy were randomly divided into two groups, heating group （n=30） using 36-37 ℃ heat washes. Room temperature group （n=30） with 20-24 ℃ room temperature flushing fluid. The patient＇s body temperature, heart rate and blood pressure changes were observed at different temperatures of fluid used during surgery, and analyzed statistically. Result At the end of surgery the temperature was （36.17±0. 40） ℃, and 6. 7% for shivering incidence in hearting group. For room temperature group was （35.31 ±0. 22） ℃ and 30 % for incidence of shivering. The mean arterial pressure and change in heart rate in hearting group was significantly lower than that of room temperature group. There was significant difference between the two groups. Conclusion Rinse solution at room temperature can cause patient＇s temperature reducing, and effect pulse, blood pressure and other vital signs. Heating rinse will effectively reduce these effect, and reduce postoperative fever, chills, and cardiovascular accidents etc.