摘要
目的:探讨保温毯联合加温冲洗液对经皮肾镜碎石术患者应激反应和术中低体温发生率的影响。方法:选取2018年1月-2020年1月本院行经皮肾镜碎石术的80例患者,按照随机数字表法分为研究组与对照组,各40例。对照组术中给予常温冲洗液,研究组术中给予保温毯联合加温冲洗液。比较两组术前、术中30 min、术毕时的心率(HR)、体温(T)及平均动脉压(MAP)。比较两组术中寒战、低体温、躁动发生率及手术相关指标。比较两组术前及术后1 d时的凝血功能与应激反应。结果:术中30 min与术毕时,对照组T与MAP均低于术前与研究组,而HR高于术前与研究组(P<0.05)。研究组术中寒战、低体温及躁动发生率均明显低于对照组(P<0.05)。研究组术中失血量、麻醉苏醒时间均明显低于对照组(P<0.05)。两组术中冲洗量与手术时间比较,差异均无统计学意义(P>0.05)。术后1 d,对照组纤维蛋白原(FIB)、活化部分凝血酶时间(APTT)、血清凝血酶原时间(PT)及凝血酶时间(TT)均高于术前与研究组(P<0.05)。术后1 d,对照组去甲肾上腺素(NE)及肾上腺素(E)及血浆皮质醇(Cor)水平均高于术前与研究组(P<0.05)。结论:保温毯联合加温冲洗液可降低经皮肾镜碎石术患者术中寒战、低体温及躁动发生率,减少术中失血量,缩短麻醉苏醒时间,维持凝血功能与应激反应的正常状态。
Objective:To investigate the effect of warm blanket combined with warm washing liquid on stress response and incidence of intraoperative hypothermia in patients with percutaneous nephrolithotripsy.Method:A total of 80 patients underwent percutaneous nephrolithotripsy in our hospital from January 2018 to January 2020 were selected.According to the random number table method,they were divided into study group and control group,40 cases in each group.The control group was given normal temperature washing liquid during the surgery,and the study group was given warm blanket combined with warm washing liquid during the surgery.The heart rate(HR),body temperature(T)and mean arterial pressure(MAP)preoperative,intraoperative 30 min and the end of the surgery were compared between the two groups.The incidence rate of intraoperative chills,hypothermia,agitation and surgery related indexes were compared between the two groups.The coagulation function and stress response before and 1 d after surgery were compared between the two groups.Result:Intraoperative 30 min and the end of the surgery,T and MAP in the control group were lower than those preoperative and those in the study group,while HR was higher than those preoperative and those in the study group(P<0.05).The incidence of intraoperative chills,hypothermia and agitation in the study group were significantly lower than those in the control group(P<0.05).The intraoperative blood loss and anaesthesia recovery time in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the amount of intraoperative irrigation and the duration of surgery between the two groups(P>0.05).1 d after surgery,fibrinogen(FIB),activated partial thrombin time(APTT),serum prothrombin time(PT)and thrombin time(TT)in the control group were higher than those preoperative and those in the study group(P<0.05).1 d after surgery,the levels of norepinephrine(NE),epinephrine(E)and plasma cortisol(Cor)in the control group were higher than those preoperative and those in the study group(P<0.05).Conclusion:The warm blanket combined with warm washing liquid can reduce the incidence of intraoperative chills,hypothermia and agitation in patients with percutaneous nephrolithotripsy,reduce the intraoperative blood loss,shorten the recovery time under anesthesia,and maintain the normal state of coagulation function and stress response.
作者
王思思
吴海萍
贺遵芳
WANG Sisi;WU Haiping;HE Zunfang(Shenzhen Third People’s Hospital,Shenzhen 518116,China;不详)
出处
《中国医学创新》
CAS
2020年第15期155-159,共5页
Medical Innovation of China
关键词
保温毯
加温冲洗液
经皮肾镜碎石术
应激反应
术中低体温
Warm blanket
Warm washing liquid
Percutaneous nephrolithotripsy
Stress response
Intraoperative hypothermia
