CAJ | 학술논문

目的：探讨使用37℃灌洗液在全麻下经皮肾镜取石术（PCNL）中对患者生命体征的影响。方法：选取2008年6月～2011年7月在我院实施PCNL术患者287例，将患者随机分为加温组（150例）和室温组（137例），术中室温组使用室温（22℃）生理盐水灌注液进行冲洗，加温组应用37℃生理盐水灌注液进行冲洗，并提高室温，注意保暖。记录手术时间及灌注液量，观察患者体温、心率、血压变化及有无寒战等。结果：两组患者手术时间及灌注液量比较差异无统计学意义( P>0.05)。室温组患者灌洗后、术毕时体温较术前显著降低( P＜0.05)，且低于加温组( P＜0.05)，而加温组患者灌洗后、术毕时体温与术前体温比较无统计学差异( P>0.05)。加温组灌洗后、术毕时动脉压升高、心率加快等改变明显低于室温组。加温组患者寒战、低体温发生率显著低于室温组，差异比较具有统计学意义(P＜0.05)。结论：术中应用加温灌注液，提高室温，注意保暖可使PCNL患者维持正常体温，减少并发症。
목적：탐토사용37℃관세액재전마하경피신경취석술（PCNL）중대환자생명체정적영향。방법：선취2008년6월～2011년7월재아원실시PCNL술환자287례，장환자수궤분위가온조（150례）화실온조（137례），술중실온조사용실온（22℃）생리염수관주액진행충세，가온조응용37℃생리염수관주액진행충세，병제고실온，주의보난。기록수술시간급관주액량，관찰환자체온、심솔、혈압변화급유무한전등。결과：량조환자수술시간급관주액량비교차이무통계학의의( P>0.05)。실온조환자관세후、술필시체온교술전현저강저( P＜0.05)，차저우가온조( P＜0.05)，이가온조환자관세후、술필시체온여술전체온비교무통계학차이( P>0.05)。가온조관세후、술필시동맥압승고、심솔가쾌등개변명현저우실온조。가온조환자한전、저체온발생솔현저저우실온조，차이비교구유통계학의의(P＜0.05)。결론：술중응용가온관주액，제고실온，주의보난가사PCNL환자유지정상체온，감소병발증。
Objective: To investigate effect of the temperature intervention on vital signs of patients receiving percutaneous nephrolithotomy (PCNL) under general anesthesia . Methods: 287 cases of PCNL surgery patients from June 2007 to July 2011 were randomly divided into heating group (150 cases) and room temperature group(137 cases), room temperature group were given irrigation with saline fluid at the room temperature of 22℃, and heating group were used 37℃saline perfusion fluid,and increasing room temperature,keeping warm. Operation time and perfusion fluid volume were recorded, body temperature,heart rate,arterial pressure and incidence of shiver were observed. Results: two groups The operation time and perfusion fluid volume were no significant differences (P>0.05). Body temperature after irrigation and after operation in room temperature group was significant lower than before operation(P<0.05), and lower than the heating group (P<0.05), while which in heating group patients had no significant difference(P>0.05). The change of arterial pressure and heart rate in heating group was lower than that in room temperature group. The incidence of shiver and hypothermia in heating group were significant lower than that in room temperature group, the differences were statistical y significant (P<0.05). Conclusion: The application of heated perfusion fluid, increasing room temperature and keeping warm enables PCNL patients to maintain normal body temperature and reduce complications.