冲洗液温度控制对接受经皮肾镜碎石术患者应激反应及凝血功能的影响

Effect of irrigation temperature control on the stress response and coagulation function in patients undergoing percutaneous nephrolithotomy

目的探讨冲洗液温度控制对接受经皮肾镜碎石术患者应激反应及凝血功能的影响。方法选择2015年4月—2016年5月收治的泌尿系结石患者108例,采用随机数字表法分为对照组和观察组,各54例。对照组采用常温冲洗,观察组采用30~35℃冲洗液冲洗。对比两组术中失血量、血小板计数和寒颤发生率,对比治疗前后应激反应及凝血功能。计数资料比较采用χ~2检验,计量资料比较采用t检验及重复测量方差分析。P<0.05为差异有统计学意义。结果观察组术中、术后心率均低于对照组(均P<0.05),体温及MAP均高于对照组(均P<0.05),观察组术后FIB、APTT、TT水平均低于对照组(均P<0.05),观察组术后血小板计数高于对照组,失血量及寒颤发生率低于对照组(均P<0.05)。结论冲洗液的温度控制在30~35℃时,不会对经皮肾镜碎石术患者的凝血功能造成影响,同时能够有效改善应激反应,减少术中失血量及寒颤发生率。

Objective To analyze the effect of irrigation temperature control on the stress response and coagulation function in patients un- dergoing percutaneous nephrolithotomy Methods A total of 108 cases undergoing pereutaneous nephrolithotomy collected from April 2015 to May 2016 were divided into two groups （54 patients in each group）. The control group was treated with normal temperature irrigation, the observation group was treated with irrigation of 30-35 ℃ . Intmopemtive blood loss, platelet count, shivering incidence, the stress response and coagulation function between the two groups were compared. Measurement data were compared by ttest and repeated ANOVA and enu- meration data were compared by Х^2 test. P〈0.05 was considered statistically significant. Results Compared with the control group, intmoperative and postoperative heart rates were lower while body temperature and MAP were higher in the observation group （all P〈0,05）. Levels of FIB, APTr, TT in the observation group were lower than the control group. In the observation group, postoperative platelet count was higher while intraoperative blood loss and shivering incidence were lower compared with the control group （all P〈0.05）. Conclusion Irrigation temperature controlled at 30-35 E will not only affect the blood coagulation function after percutaneous nephrolithotomy, but also effectively improve the stress response, reduce intraoperative blood loss and shivering incidence.