经皮肾镜取石术中灌洗液对体温的影响

Influence of perfusion fluid on body temperature in percutaneous nephrolithotomy

目的观察常温和加温灌洗液在经皮肾镜取石术(percutaneous nephrolithotripsy,PCNL)中对体温的影响。方法 54例行PCNL的患者,采用随机数字表法随机分为2组:常温灌洗液组(A组)和加温灌洗液组(B组),2组患者在室温相同的环境下麻醉诱导后由鼻孔置入体温探头,分别记录基础体温(T0)以及手术开始15min,30min,45min,60min体温(T)的变化。结果 2组患者在年龄,体重,基础体温(T0),手术开始15min(T1),30min(T2)以及术中灌洗液用量比较无统计学意义(P>0.05);A组患者在手术进行45min(T3),60min(T4)时体温下降程度与B组比较有统计学意义(P<0.05);A组患者在复苏室滞留时间显著高于B组(P<0.01);术后寒颤的发生率高于B组(P<0.05)。结论使用温灌洗液效果确切,能显著降低PCNL患者术后寒颤的发生率,缩短在复苏室滞留的时间,降低术后低温带来的一系列并发症,确保苏醒质量与围术期安全。

Objective To observe the effects of normal temperature and warm lavage fluid on body temperature in percutaneous nephrolithotripsy（PCNL）. Methods Fifty-four patients with PCNL were randomly divided into two groups：group A（normothermic fluid group）and group B（warming fluid group）. Patients in both groups were anesthetized under the same room temperature After induction, the body temperature probe was inserted into the nostrils to record the change of body temperature（T0） and body temperature（T） at 15 min, 30 min, 45 min and 60 min respectively. Results There was no significant difference in age, body weight, basal body temperature（T0）, 15 min（T1）, 30 min（T2） and intraoperative lavage fluid volume between the two groups（P〉0.05） The decrease of body temperature at 45 min（T3） and60 min（T4） was statistically significant compared with that of B group（P〈0.05）. The retention time of A group was significantly higher than that of B group（P〈0.01））; The incidence of postoperative chills was higher than that in group B（P〈0.05）. Conclusion The use of warm lavage fluid is effective and can significantly reduce the incidence of postoperative chills in PCNL patients, shorten the retention time in the recovery room and reduce postoperative complications caused by low temperature to ensure the quality of recovery and perioperative safety.