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目的探讨冲洗液温度控制对接受经皮肾镜碎石术患者应激反应及凝血功能的影响。方法选择2015年4月—2016年5月收治的泌尿系结石患者108例,采用随机数字表法分为对照组和观察组,各54例。对照组采用常温冲洗,观察组采用30~35℃冲洗液冲洗。对比两组术中失血量、血小板计数和寒颤发生率,对比治疗前后应激反应及凝血功能。计数资料比较采用χ~2检验,计量资料比较采用t检验及重复测量方差分析。P<0.05为差异有统计学意义。结果观察组术中、术后心率均低于对照组(均P<0.05),体温及MAP均高于对照组(均P<0.05),观察组术后FIB、APTT、TT水平均低于对照组(均P<0.05),观察组术后血小板计数高于对照组,失血量及寒颤发生率低于对照组(均P<0.05)。结论冲洗液的温度控制在30~35℃时,不会对经皮肾镜碎石术患者的凝血功能造成影响,同时能够有效改善应激反应,减少术中失血量及寒颤发生率。
Objective To investigate the effect of rinse fluid temperature control on stress response and coagulation function in patients undergoing percutaneous nephrolithotomy. Methods A total of 108 patients with urinary calculi treated in our hospital from April 2015 to May 2016 were randomly divided into control group and observation group with 54 cases in each group. The control group was rinsed at room temperature and the observation group was rinsed with rinse solution at 30 ~ 35 ℃. The blood loss, platelet count and incidence of chills were compared between the two groups, and the stress response and coagulation function were compared before and after treatment. Counting data were compared using χ ~ 2 test, measurement data were compared using t test and repeated measures analysis of variance. P <0.05 for the difference was statistically significant. Results The heart rate of the observation group was lower than that of the control group (all P <0.05), and the body temperature and MAP were higher than those of the control group (all P <0.05). The FIB, APTT and TT levels of the observation group were lower than those of the control group (All P <0.05). The postoperative platelet count in the observation group was higher than that in the control group, and the incidence of hemorrhage and chills were lower than those in the control group (all P <0.05). Conclusion When the temperature of rinsing liquid is controlled at 30 ~ 35 ℃, it will not affect the coagulation function of patients undergoing percutaneous nephrolithotomy, meanwhile it can effectively improve the stress response and reduce the intraoperative blood loss and the incidence of chills.