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目的探讨变温水毯在经皮肾镜超声弹道碎石(PCNL)术中的应用效果。方法采用随机数字表法将择期行PCNL术的80例患者分为对照组和观察组,每组40例,均在翻身俯卧位时铺设变温水毯,观察组随后启动水循环,水温设定41℃,对照组则不启动。在俯卧位后(T1)、碎石开始(T2)、碎石30 min(T3)等时间点,分别记录温度、血压、心率等生命体征,术后观察患者低体温发生率。结果在体温方面,观察组在T1、T2、T3时间点相互比较,差异无统计学(P>0.05),对照组患者T1、T2、T3时点相互比较,差异有统计学意义(P<0.01),两组患者在T1时点比较,差异无统计学意义(P>0.05),在T2、T3时点比较,差异有统计学意义(P<0.01)。血压方面,观察组在T1、T2、T3时点相互比较,差异无统计学意义(P>0.05),对照组患者在T1、T2、T3时点相互比较存在统计学差异(P<0.01),两组患者在T1时点无统计学差异(P>0.05),在T2、T3时点收缩压比较,差异有统计学意义(P<0.01)。心率方面,观察组在T1、T2、T3时点相互比较,差异无统计学意义(P>0.05),对照组患者T1、T2、T3时点相互比较,差异统计学意义(P<0.01),两组患者在T1时点比较,差异无统计学意义(P>0.05),在T2、T3时点存在统计学差异(P<0.01)。观察组术后发生低体温3例,发生率为7.5%;对照组术后发生低体温12例,发生率30.0%。两组低体温发生率比较,差异有统计学意义(P<0.05)。结论变温水毯用于PCNL术的保温效果明显,可减少热量的散失,有利于温度的恢复与恒定,减轻心脏负荷,值得推广与应用。
Objective To investigate the effect of variable temperature water blanket in percutaneous nephrolithotomy (PCNL). Methods Eighty patients undergoing PCNL undergoing elective surgery were randomly divided into control group and observation group with 40 cases in each group. All of them were set up warm water blanket in prone position, and the observation group then started water cycle. The water temperature was set at 41 ℃ , The control group did not start. After the prone position (T1), gravel start (T2), gravel 30min (T3) and other time points, were recorded temperature, blood pressure, heart rate and other vital signs, postoperative observation of the incidence of hypothermia in patients. Results In body temperature, the observation group at T1, T2, T3 time points compared with each other, the difference was not statistically significant (P> 0.05), the control group of patients at T1, T2, T3 time points compared with each other, the difference was statistically significant ). There was no significant difference between the two groups at T1 time point (P> 0.05). There was significant difference between T2 and T3 time points (P <0.01). Blood pressure, the observation group at T1, T2, T3 time points compared with each other, the difference was not statistically significant (P> 0.05), the control group of patients at T1, T2, T3 time points compared with each other statistically significant difference (P < There was no significant difference between the two groups at T1 (P> 0.05). There was significant difference in systolic pressure at T2 and T3 (P <0.01). Heart rate, the observation group at T1, T2, T3 time points compared with each other, the difference was not statistically significant (P> 0.05), control group patients T1, T2, T3 time points compared with each other, the difference was statistically significant (P <0.01) There was no significant difference between the two groups at T1 (P> 0.05). There was a significant difference at T2 and T3 (P <0.01). Postoperative hypothermia in observation group occurred in 3 cases, the incidence was 7.5%; control group occurred in 12 cases of hypothermia, the incidence rate of 30.0%. The incidence of hypothermia between the two groups, the difference was statistically significant (P <0.05). CONCLUSION: The thermal insulation effect of PCHL is better than PCNL, which can reduce the loss of heat, is conducive to the recovery and constant of temperature, and relieves the heart load. It is worth to promote and apply.