摘要
目的探讨不同温度灌注液对经皮肾镜取石术(PCNL)患者生命体征及并发症发生率的影响,为临床灌注液温度的选择提供依据。方法前瞻性选取2019年7月至2020年7月经CT确诊为复杂性肾结石的患者80例,按照随机数字表分为等体温组、等室温组,每组40例。等体温组与等室温组灌洗液温度分别为35~37℃、24~26℃。采用t检验比较术前、术中及术后1 h患者的体温、心率、平均动脉压等生命体征;采用χ^(2)检验比较并发症发生率。结果两组术前体温差异无统计学意义(t=0.351,P>0.05);等体温组术中与术后1 h的体温均明显高于等室温组,差异具有统计学意义(t值分别为25.608、21.380;P值均<0.05)。等体温组并发症发生率10.0%,明显低于等室温组的30.0%,差异具有统计学意义(χ^(2)=5.000,P<0.05)。两组术前心率与平均动脉压比较差异均无统计学意义(t值分别为0.114、0.151;P值均>0.05);等体温组术中和术后1 h的心率与平均动脉压变化幅度小于等室温组,差异具有统计学意义(t值分别3.194、8.078,8.963、11.663;P值均<0.05)。结论PCNL过程中采用等体温灌洗液,不仅可以维持患者血流动力学稳定,预防低体温,还能够减少并发症的发生。
Objective To explore the influence of different temperature perfusion fluid on the vital signs and complication rate of patients undergoing percutaneous nephrolithotomy(PCNL)and to provide a basis for the selecting clinical perfusion fluid temperature.Methods According to the randomn table,a prospective selection of 80 patients diagnosed with complicated kidney stones by CT from July 2019 to July 2020 was divided into body-temperature and indoor-temperature groups,with 40 cases in each group.The temperature of the lavage fluid in the body-temperature group and the indoor-temperature group were 35~37℃ and 24~26℃ respectively.The t test was used to compare the patient's body temperature,heart rate,mean arterial pressure,and other vital signs before,during,and 1 h after surgery.The incidence of complications was compared with χ^(2) test.Results The preoperative body temperature difference between the two groups was not statistically significant(t=0.351,P>0.05);the body temperature of the body-temperature group during the operation and 1 h after the operation was significantly higher than that of the indoor-temperature group,and the difference was statistically significant(t=25.608,21.380;all P<0.05).The complication rate in the body-temperature group was 10.0%,which was significantly lower than the 30.0% in the indoor-temperature group,and the difference was statistically significant(χ^(2)=5.000,P<0.05).There was no significant difference in heart rate and mean arterial pressure between the two groups before operation(t=0.114,0.151;all P>0.05);the changes in heart rate and mean arterial pressure during operation and 1 h after operation in the body-temperature group were smaller than those in the indoortemperature group,The difference was statistically significant(t=3.194,8.078,8.963,11.663;all P<0.05).Conclusion The application of body-temperature lavage fluid during the PCNL process can maintain the stability of the patient´s hemodynamics,prevent hypothermia,and reduce the occurrence of complications.
作者
闫学川
张艳春
YAN Xuechuan;ZHANG Yanchun(Department of Urology,Sunshine Union Hospital,Shandong Weifang 261000,China)
出处
《中国研究型医院》
2021年第3期44-47,共4页
Chinese Research Hospitals
关键词
肾结石
碎石术
肾造口术
经皮
体征和症状
Kidney calculi
Lithotripsy
Nephrostomy,percutaneous
Signs and symptoms
