一次性手术洞巾联合脑外科3L贴膜在经皮肾镜碎石术中的应用

Application of disposable surgical hole towel combined with brain surgery 3L film in percutaneous nephrolithotomy

目的:探讨一次性手术洞巾联合脑外科3L贴膜在经皮肾镜碎石(percutaneous nephrolithotomy,PCNL)术中的应用对患者的影响。方法:采用随机数字表法将2016年9月至2017年6月中南大学湘雅医学院附属株洲医院行PCNL术的80例符合标准的患者分为观察组(40例)与对照组(40例)。对照组行常规铺单法,术野常规贴脑外科3L贴膜,观察组在常规铺单基础上用一次性手术洞巾联合脑外科3L贴膜。比较两种方法对患者体温、收缩压、心率、麻醉复苏时间、低体温发生率及术后3个月结石清除率的影响。结果:观察组手术时间为(87.17±13.32)min,对照组为(91.45±11.20)min,差异无统计学意义(t=1.553,P=0.124)。两组入手术室时体温、收缩压、心率比较,差异无统计学意义(P>0.05),术中碎石30min、术中碎石60min及离开复苏室时,观察组的体温、收缩压、心率与对照组比较,差异有统计学意义(P<0.05)。观察组麻醉复苏时间明显比对照组缩短(t=-2.864,P=0.005),术中低体温发生率明显比对照组降低(χ~2=7.470,P=0.006),但术后3个月复查结石清石率,两组无明显差别(χ~2=0.105,P=0.745)。结论:在PCNL术中使用一次性手术洞巾联合脑外科3L贴膜,能有效预防灌洗液浸湿手术单及患者身体,保持患者在术中身体干燥、清洁,维持患者生命体征恒定,缩短患者麻醉复苏时间,降低低体温发生率,值得在临床推广应用。

Objective： To investigate the effect of a disposable surgical hole towel combined with a brain surgery 3 L film on patients with percutaneous nephrolithotomy（PCNL）. Methods： Eighty patients who met the standard of PCNL from September 2016 to June 2017 in our hospital were randomly divided into an observation group（40 cases） and control group（40 cases） by random number table method. In the control group, the conventional paving method was applied, the operative field was attached to the brain surgery 3 L film, and the observation group was treated with a disposable surgical hole towel combined with brain surgery 3 L film to prevent the intraoperative lavage fluid soaking the operation list and the patient＇s body. The effect of the two methods on the patient＇s body temperature, systolic blood pressure, heart rate, anesthesia recovery time, incidence of hypothermia, and stone clearance rate after 3 months were compared. Results： The operation time was（87.17±13.32） min in the observation group and（91.45±11.20） min in the control group（t=1.553, P=0.124）. There was no statistically significant difference in body temperature, systolic blood pressure, and heart rate between the two groups when they were in the operating room（P〈0.05）. During the 30 minutes of intraoperative stone breakage, 60 minutes of intraoperative stone breakage, and 60 minutes of surgery, the body temperature and contraction of the observation group were observed. The difference between pressure and heart rate and the control group was statistically significant（P〈0.05）. The anesthesia resuscitation time in the observation group was significantly shorter than that in the control group（t=-2.864, P=0.005）. The incidence of hypothermia was significantly lower in the observation group than in the control group（χ^2=7.470, P=0.006）, but 3 months after operation. The rate of stone clearance was no significant difference between the two groups（χ^2=0.105, P=0.745）. Conclusion： The use of disposable surgical hole towel and brain surgery 3 L film in PCNL can effectively prevent the lavage fluid from infiltrating the operation list and the patient＇s body, keep the patient dry and clean during the operation, maintain the patient＇s vital signs constant, shorten the patient＇s anesthesia recovery time, and reduce the incidence of hypothermia, it is worth promoting in clinical practice.