不同温度灌注液对经皮肾镜碎石取石术中患者机体的影响

Influence of Percutaneous Nephrolithotomy Lithotripsy Perfusion Under Different Fluid Temperature

目的：为经皮肾镜碎石取石术灌注液温度的选择提供科学依据。方法将80例经皮肾镜碎石取石术患者随机分为加温组40例，手术时采用36℃～37℃的加温灌注液，室温组40例采用25℃室温灌注液。比较两组手术时间、灌注量，手术中动态监测两组患者体温、心率、血压等生命体征变化，比较两组术后寒战、烦躁、心律失常等不良反应的发生率。结果加温组和室温组手术时间、灌注量无显著差异（ P ＞0．05）；与加温组相比，室温组患者术中体温显著降低、心率显著增高，差异均有统计学意义（ P＜0．05），两者之间血压无统计学差异，加温组术后寒战、烦躁、心律失常等不良反应发生率均低于室温组，差异有统计学意义（P＜0．05）。结论 经皮肾镜手术采用室温灌注液可引起低体温，心率增高，术后寒战、烦躁、心律失常等不良反应，采用加温灌注液可以减少对患者机体的不良影响，提高手术安全性。

Objective To provide a scientific basis for percutaneous nephrolithotomy lithotripsy perfusion fluid temperature selection. Methods The 80 cases of percutaneous nephrolithotomy lithotripsy were randomly divided into 40 cases in warmed group under 36℃~37℃during surgery.40 cases in the room temperature group is under 25℃ambient temperature using perfusion fluid.Operative time and perfusion were compared, and the changes of body temperature, heart rate, blood pressure and other vital signs were dynamically moni-tored.Comparison of postoperative shivering, irritability, arrhythmia incidence of adverse reactions of the two groups was done.Results There was no significant difference of operation time and perfusion in warmed group and room temperature group （P〉0.05）.Compared with the warmed group, patients in room temperature group significantly had body temperature decreased, and heart rate increased.The differences were statistically significant （P〈0.05）.There was no significant difference in blood pressure between the two groups.Heating postoperative shivering, irritability, arrhythmias and other adverse reactions were lower than room temperature group, and the difference was statistically significant （ P〈0.05 ） .Conclusion Percutaneous nephrolithotomy surgery using perfusion solution at room temperature can cause hypothermia, increased heart rate, postoperative shivering, irritability, arrhythmias and other adverse reactions.Using perfusion fluid heating can reduce the adverse effects on the patients′body, and improve surgical safety.