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目的探讨灌洗液温度对微创经皮肾镜钬激光碎石术(MPCNL)患者体温、HR和MAP的影响。方法 60例MPCNL患者随机均分为两组:A组术中采用置于恒温箱中37℃的灌洗液;B组采用室温下放置的灌洗液。两组患者均给予常规的保暖措施,静脉输液采用Hotlime液体加温器加温,输入体内的液体温度为37℃。比较两组术前和手术30、60和90min时的体温、HR和MAP的变化,记录寒战发生情况。结果两组患者术前体温、HR和MAP无统计学差异(P>0.05)。手术30、60和90min时,B组体温低于A组[(36.1±0.3)℃vs.(36.4±0.2)℃、(33.6±0.2)℃vs.(36.4±0.2)℃和(35.6±0.5)℃vs.(36.2±0.2)℃](P<0.05或P<0.01),而HR和MAP高于A组(P<0.05或P<0.01);B组术中寒战发生率高于A组(33.3%vs.6.7%)(P<0.01)。结论 MPCNL术中采用37℃的加温灌洗液,配合常规的保暖措施,可以有效预防低体温的发生,有利于维持循环稳定和术后康复。
Objective To investigate the effect of perfusate temperature on body temperature, HR and MAP in patients with minimally invasive percutaneous nephrolithotomy and holmium laser lithotripsy (MPCNL). Methods Sixty patients with MPCNL were randomly divided into two groups: Group A received intraperitoneal (37 ℃) lavage fluid at room temperature; Group B received lavage fluid at room temperature. Two groups of patients were given conventional warm-keeping measures, intravenous infusion using Hotlime liquid warmer heating, the input liquid temperature of 37 ℃. The changes of body temperature, HR and MAP at 30, 60 and 90 min were compared between the two groups, and the occurrence of chills was recorded. Results There was no significant difference in preoperative body temperature, HR and MAP between the two groups (P> 0.05). At 30, 60 and 90 minutes of operation, the body temperature in group B was significantly lower than that in group A [(36.1 ± 0.3) ℃ vs (36.4 ± 0.2) ° C, (33.6 ± 0.2) ° C and (36.4 ± 0.2 ° C) ) Vs (36.2 ± 0.2) ° C] (P <0.05 or P <0.01), HR and MAP were higher in group A than in group A (P <0.05 or P <0.01) (33.3% vs.6.7%) (P <0.01). Conclusion MPCNL using 37 ℃ warming lavage fluid, with conventional warm measures, can effectively prevent the occurrence of hypothermia, is conducive to maintaining stable circulation and postoperative rehabilitation.