充气加温仪预加温在经皮肾镜碎石取石术中的应用效果及对术中核心体温、应激反应的影响

Application effect of pre-heating with inflatable heating device in percutaneous nephrolithotomy and its influence on core body temperature and stress response during operation

目的探讨充气加温仪预加温在经皮肾镜碎石取石术(PCNL)中的应用效果及对患者术中核心体温变化、应激反应的影响。方法选取2020年1月至2021年9月至广东省云浮市人民医院接受PCNL治疗的160例患者作为研究对象,采用随机数字表法将其分为观察组和对照组,每组80例,对照组术中予以常规保温措施,观察组采用充气加温仪预加温辅助手术,记录并比较两组患者实施麻醉诱导30、60、90 min时的核心体温变化情况,比较两组患者手术耗时、术中出血量、输液量、冲洗液量、麻醉苏醒时间、住院时间等围手术期临床指标,比较两组患者术中低体温、体温恢复慢、术后寒战等应激反应发生情况。结果两组患者麻醉诱导30 min后核心体温比较,差异无统计学意义(P>0.05),麻醉诱导60、90 min后观察组的核心体温高于对照组,差异有统计学意义(P<0.05);观察组的麻醉苏醒时间、住院时间短于对照组,差异有统计学意义(P<0.05),两组患者的手术耗时、术中出血量、输液量、冲洗液量比较,差异无统计学意义(P>0.05);观察组应激反应总发生率为12.50%(10/80),低于对照组的27.50%(22/80),差异有统计学意义(P<0.05)。结论在PCNL术中采用充气加温仪对患者进行预加温可有效维持其术中核心体温水平,此设备辅助不会影响到患者正常手术流程,但可有效促进其术后苏醒并缩短其术后住院时间,且经充气加温仪做预加温处理后患者术中、术后发生应激反应的风险更低,更有利于术后恢复,具有较高临床应用价值。

Objective To investigate the application effect of inflatable heater pre-heating in percutaneous nephrolithotriptomy(PCNL)and its effect on the changes of core body temperature and stress response of patients during operation.Methods A total of 160 cases of patients admitted to Yunfu People′s Hospital for PCNL from January 2020 and September 2021 were selected as the research objects,they were divided into the observation group and control group according to the random number table method,with 80 cases in each group.Control group uses conventional heat preservation measures,observation group uses temperature aeration and pre-heating assisted surgery,the changes of core body temperature between the two groups were recorded and compared,30,60 and 90 min after induction of anesthesia,and the perioperative clinical indicators such as operation time,intraoperative blood loss,infusion volume,flushing fluid volume,anesthesia recovery time and hospital stay were compared between the two groups.The occurrence of intraoperative hypothermia,slow body temperature recovery,postoperative chills and other stress reactions were compared between the two groups.Results There was no significant difference in core body temperature between the two groups after 30 min of induction of anesthesia(P>0.05).The core body temperature of the observation group was higher than that of the control group after 60 and 90 min of induction of anesthesia,and the difference was statistically significant(P<0.05).The observation group′s recovery time from anesthesia and hospital stay were shorter than those of the control group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in the operation time,intraoperative blood loss,infusion volume,and irrigation volume between the two groups(P>0.05).The total incidence of stress reaction in the observation group was 12.50%(10/80),which was lower than 27.50%(22/80)in the control group,the difference was statistically significant(P<0.05).Conclusion Intraoperative use of inflatable thermometer for patients in PCNL with pre-heating can effectively maintain the intraoperative core body temperature level,this auxiliary equipment does not affect the normal operation process,but can effectively promote the emergence and shorten the postoperative hospital stay,the risk of intraoperative and postoperative stress reaction is lower after pre-heating with inflatable heater,which is more conducive to postoperative recovery,and has high clinical application value.