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目的探讨在经皮肾镜取石术中应用两种温度生理盐水作为灌注液对患者体温变化的影响。方法 36例经皮肾镜取石术中患者随机分为加温组19例,常温组17例,加温组使用温箱加温到37℃的生理盐水,常温组使用室温22℃下放置的生理盐水。观察两种方法患者术中和术后心率、体温变化及术中躁动和寒战发生率。结果加温组围手术期的心率的变化较平稳,术前、术中、术后无差异。常温组围手术期的心率波动明显,术前、术中、术后有差异(P<0.05)。加温组围手术期的体温在正常范围内波动,术前、术中、术后无差异。常温组围手术期的体温下降明显(P<0.01)。加温组较常温组躁动和寒战的发生率少(P<0.05)。结论使用加温至37℃的生理盐水作为灌注液可以有效维持患者围手术期的正常心率和体温,减少了躁动和寒战的发生。
Objective To investigate the effect of two temperature physiological saline as perfusion fluid on temperature change in patients undergoing percutaneous nephrolithotomy. Methods Thirty-six patients undergoing percutaneous nephrolithotomy were randomly divided into warming group (n = 19) and normothermia group (n = 17). The warming group was warmed to 37 ℃ and the normal temperature group was placed at room temperature brine. Intraoperative and postoperative heart rate, body temperature and intraoperative agitation and chills incidence were observed in the two methods. Results In the warming group, the changes of heart rate during perioperative period were relatively stable, and there was no difference in preoperative, intraoperative and postoperative. The heart rate fluctuated significantly during the perioperative period in the normal temperature group, with significant difference before and during operation and after operation (P <0.05). Warming group perioperative temperature fluctuations in the normal range, no difference before, during, and after surgery. Body temperature decreased significantly during the perioperative period (P <0.01). The incidence of agitation and chills was lower in warming group than in normal temperature group (P <0.05). Conclusion The use of physiological saline warmed to 37 ℃ as perfusion fluid can effectively maintain the normal heart rate and body temperature during perioperative period and reduce the restlessness and chills.