水循环保温毯联合加温冲洗液对经皮肾镜碎石术患者应激反应和低体温的影响

Effect of water cycle insulation blanket combined with warmed irrigation fluids on stress response and hypothermia in patients undergoing percutaneous nephrolithotomy

目的探究水循环保温毯联合加温冲洗液对经皮肾镜碎石术患者术中应激反应和低体温的影响。方法选取2017年7月至2019年5月于广东省第二中医院行经皮肾镜碎石术治疗的患者350例,随机分为观察组和对照组,各175例。对照组患者采用常规保温护理,观察组患者采用水循环保温毯联合加温冲洗液进行护理。比较两组术前、术中和术后的应激反应指标,及术中低体温、躁动、寒战的发生率和手术时间、术中出血量。结果术前,两组心率(HR)、平均动脉压(MAP)和体温比较差异均无统计学意义(P值均>0.05)。术中和术后,观察组的HR显著低于对照组,MAP和体温均显著高于对照组(P值均<0.05)。观察组术中低体温、躁动和寒战发生率均显著低于对照组(P值均<0.05)。观察组术中出血量显著少于对照组(P<0.05),而两组手术时间比较差异无统计学意义(P>0.05)。结论将水循环保温毯联合加温冲洗液应用于经皮肾镜碎石术中,有利于稳定患者生命体征,改善机体应激反应,减少术中出血量,降低低体温、寒战和躁动发生率。

Objective To explore the effect of water cycle insulation blanket combined with warmed irrigation fluids on intraoperative stress response and hypothermia in patients undergoing percutaneous nephrolithotomy.Methods 350 patients who underwent percutaneous nephrolithotomy in Guangdong Second Hospital of Traditional Chinese Medicine from July 2017 and May 2019 were selected and randomly divided into an observation group and a control group,with 175 patients in each group.The control group was given routine thermal nursing,and the observation group was given water cycle insulation blanket combined with warmed irrigation fluids.The preoperative,intraoperative and postoperative stress response indicators,the incidence of hypothermia,restlessness and chills,the operation time and the amount of blood loss during the operation were compared between the two groups.Results Before surgery,there were no significant differences in heart rate(HR),mean arterial pressure(MAP)and body temperature between the two groups(all P>0.05).During and after the operation,the HR of the observation group was significantly lower than that of the control group,and the MAP and body temperature were significantly higher than those of the control group(all P<0.05).The incidence of intraoperative hypothermia,restlessness and chills of the observation group was significantly lower than those of the control group(all P<0.05).The intraoperative blood loss of the observation group was significantly less than that of the control group(P<0.05),but there was no significant difference in the operation time between the two groups(P>0.05).Conclusion The use of water cycle insulation blanket combined with warmed irrigation fluids in percutaneous nephrolithotomy is beneficial to stabilize patients vital signs,improve the stress response,reduce the intraoperative blood loss,and reduce the incidences of hypothermia,chills and restlessness.