国际麻醉学与复苏杂志   2013, Issue (8): 3-3
    
温灌洗液降低经皮肾镜取石术围术期寒颤的发生率
高成顺1()
1.大连医科大学附属二院
The lukewarm lavage reducing percutaneous nephrolithotomy lithotomy perioperative chills incidence
 全文:
摘要:

目的 探讨温灌洗液在经皮肾镜取石术(PCNL)中的应用效果。方法 120例全麻下PCNL患者,采用随机数字表法随机分为三组(n=40),Ⅰ组(室温静脉输液和室温灌洗液组);Ⅱ组(室温静脉输液和温灌洗液组);Ⅲ组(温静脉输液和温灌洗液组)。各组均在室温相同的条件下麻醉,统计静脉输液总量和灌洗液总量,同时记录有创平均动脉压、中心静脉压、围术期平均体温以及术后寒颤发生的比例。结果 Ⅰ、Ⅱ组患者苏醒期平均体温低于术中平均体温0.7℃左右,组内比较有统计学差异(P<0.05);Ⅲ组患者苏醒期与术中平均体温相比变化不大,组内比较无统计学差异(P>0.05)。Ⅰ组患者术中及苏醒期平均体温低于Ⅱ、Ⅲ组,术后寒颤发生的比例Ⅰ组为57.5%、Ⅱ组为32.5%、Ⅲ组为17.5%,组间比较有统计学差异(P<0.05);Ⅱ组患者术中和苏醒期平均体温以及术后寒颤发生的比例与Ⅲ组比较有统计学差异(P<0.05)。结论 温灌洗液在经皮肾镜取石术中的应用可以有效减少围术期寒颤的发生率,对患者呼吸、循环功能无显著影响,安全有效。

关键词: 灌洗液;经皮肾镜;全身麻醉;术后寒战
Abstract:

Objective: To observe the effect to patients of applying lukewarm lavage fluid in percutaneous nephrolithotomy. Method: 120 cases of undergoing percutaneous nephrolithotomy patients who received general anesthesia and endotracheal intubation Using a random number table, were randomly divided into three groups(40 cases in each group). Intravenous fluids and lavage group at room temperature used in Group I; Room temperature intravenous fluids and lukewarm lavage used in Group II; Lukewarm intravenous fluids lavage used in Group III. Patients in each group received general anesthesia with intubation at the same room temperature. Total volume of intravenous fluids and lavage during operation were recorded, as well as patient's temperature, mean arterial pressure and central venous pressure. The mean temperature during surgery and waking period, and the incidence of postoperative shivering were taken into statistical analysis. Results: Temperature in Group I and II during waking period significantly lower than (P<0.05) mean temperature during surgery 0.7℃.Group I patients recovery period average body temperature less than group II and III, the proportion of chills occur of postoperative,group I 57.5% ,group II 32.5%, group III 17.5% .Between the two groups statistically were significant different(P <0.05); The mean temperature during surgery and waking period in Group I, as well as the incidence of postoperative shivering, were significantly lower than (P<0.05) those in Group II and III. Conclusion: Lukewarm lavage can be effective in reducing the incidence of postoperative shivering in percutaneous nephrolithotomy, without side effect to patient's perioperative circulatory function.

Key words: lavage; percutaneous nephrolithotomy; general anesthesia; postoperative shivering;