护理干预预防经皮肾镜取石术后低体温的效果

Effect of nursing intervention on preventing hypothermia in patients with complicate renal calculi treated with percutaneous nephrolithotomy

目的探讨护理干预预防复杂性肾结石患者，行经皮肾镜取石术发生低体温的方法及效果。方法将2006年1月至2010年7月复杂性肾结石经皮肾镜取石术患者112例应用计算简单随机方法随机分为对照组和观察组，每组56例。对照组术中按常规进行护理，观察组术中在常规护理的基础上，提高室温至24—26℃，输注液体、灌洗液加温至37℃，并采取保温措施。于患者人手术室时（术前）、术毕测量并记录体温、脉搏、血压；观察术中术后寒战、躁动的发生情况。结果观察组术毕体温（35．2±1．0）℃显著高于对照组（34．6±1．6）℃，差异具有统计学意义（t=5．7，P〈0．01）；术后收缩压、心率显著低于对照组，分别为（137．2±16．6）mmHg和（142．2±28．8）mmHg，（89．9±9．5）次／min和（101．9±9．5）次／min，组间差异具有统计学意义（t=4．10，3．55；P〈0．05）；寒战、躁动发生率显著低于对照组，组间比较差异具有统计学意义（X2=0．45，0．67；P〈0．01）。观察组术中出血量及输血率与对照组差异无统计学意义（t=0．55，0．61；P〉0．05）。结论术前、术中积极采取有效保温措施干预，可明显降低复杂性肾结石行PCNL术患者低体温的发生。

Objective To explore the nursing methods for preventing hypothermia in patients with complicate renal calculi treated with percutaneous nephrolithotomy and its effects. Methods One hundred and twelve patients who suffered from complicate renal calculi and were treated with percutaneous nephrolithotomy from January 2006 to July 2010 were randomly divided into two groups, experiment group （n = 56） and control group （n = 56）. The control group was administered with traditional nursing methods, while the experiment group, besides the traditional methods, were nursed with warming measures, such as room temperature elevated up to 24 - 26 degrees centigrade, infusion fluid and irrigating solutions warmed up to 37 degrees centigrade. The body temperature, pulse rate and blood pressure in both groups were measured and recorded before and after the surgery, respectively, and the results were compared. The chill and restlessness in both groups were observed. Results The body temperature in the experiment group [ （35.2 ± 1. 0） degrees centigrade ] was significantly higher than that in the control group [ （ 34.6 ± 1.6 ） degrees centigrade ] （ t = 5. 7, P 〈 0. 01 ） ; heart rate [ （ 137.2 ± 16.6 ）mm Hg ], systolic blood pressure [ （89.9± 9.5） beats/min ] in the experiment group were significantly lower than those in the control group [ （ 142.2 ±28.8） mm Hg, （ 101.9 ± 9.5 ） beats/min ] （ t = 4. 10,3.55 ;P 〈 0. 05 ） ; the occurahce rate of chills, restlessness in the experiment group were significantly lower than those in the control group （ X2 = 0.45, 0. 67 ; P 〈 0. 01 ）. There were no significant differences between observed blood loss and transfusion rate in both groups （ t = 0. 55, 0. 61 ; P 〉 0. 05）. Conclusions Appropriate nursing interventions, such as internal and external rewarming techniques or drug administration, could prominently reduce the incidence rate of hypothermia in patients with complicate renal ealeuli treated with pereutaneous nephrolithotripsy.