灌洗液温度对腰麻下经尿道前列腺电切术患者中心体温和血流动力学的影响

Effects of irrigation fluid temperature on body temperature and hemodynamics in patients with lumbar anesthesia by transurethral resection of the prostate

目的观察灌洗液温度对腰麻下经尿道前列腺电切术(TURP)患者中心体温和血流动力学的影响。方法选择腰麻下行TURP的老年患者80例,随机分为2组,每组40例。对照组膀胱尿道灌洗液为室温液体(21℃),试验组膀胱尿道灌洗液为加温液体(37℃)。2组患者均连续监测收缩压(SBP)、舒张压(DBP)、心率(HR)及体温,术中每10 min对患者进行寒战评分并记录。结果对照组患者在手术前体温为(36.79±0.05)℃,手术结束时下降至(34.59±0.14)℃,降低了2.2℃;试验组手术前体温为(36.89±0.04)℃,手术结束时为(36.17±0.59)℃,体温降低了0.72℃,2组患者间体温变化比较差异有统计学意义(P<0.05)。对照组术中寒战发生率(18例,45%)显著高于试验组(6例,15%)(P<0.05)。2组患者血流动力学指标变化比较差异无统计学意义。结论 TURP中应用加温灌洗液(37℃)可有效地预防围术期低体温的发生,减少寒战的发生。

Objective To observe the effects of irrigation fluid temperature on body temperature and hemodynamics in patients with lumbar anesthesia by transurethral resection of the prostate. Methods Eighty cases aged 59-91 years receiving transurethral resection of prostate under lumbar anesthesia were randomly divided into two groups with forty cases in each group. Patients received irrigation fluid at room temperature （21 ℃ ） in control group, and in the experimental group, patients received warm irrigation fluid （37 ℃ ）. Systolic pressure, diastolic pressure, heart rate and core temperature were assessed in all patients during the operation,and shivering score was evaluated every 10 minutes during surgery. Results Core temperature of the control group dropped from 36. 79±0. 05 ℃ before operation to 34. 59±0. 14 ℃ in postoperative period. Core temperature of the experimental group dropped from 36. 89±0. 04 ℃ before operation to 36. 17 ±0. 59 ℃ in postoperative period. Temperature changes between the two groups had significant difference （P〈0. 05）. There was no significant difference in hemodynamics between two groups. The incidence of shivering in control group and experimental group was 45% （18 cases） and 15% （6 cases）, which had significant difference between two groups （P〈 0. 05）. Conclusions Perioperative hypothermia and shivering are effectively prevented in TURP patients by using warm irrigation fluid （ 37 ℃ ）.