国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2013年
8期
684-686
,共3页
灌洗液%经皮肾镜%全身麻醉%术后寒战
灌洗液%經皮腎鏡%全身痳醉%術後寒戰
관세액%경피신경%전신마취%술후한전
Lavage%Percutaneous nephrolithotomy%General anesthesia%Postoperative shivering
目的 探讨温灌洗液在经皮肾镜取石术(pereutaneous nephrolithotripsy,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3组(每组40例):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(mean arterial pressure,MAP)、中心静脉压(central venous pressure,CVP)、围术期平均体温以及术后寒战发生的比例. 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,组内比较差异有统计学意义(P＜0.05)；Ⅲ组患者苏醒期与术中平均体温相比变化不大,组内比较差异无统计学意义(P＞0.05).Ⅰ组患者术中及苏醒期平均体温低于Ⅱ、Ⅲ组,术后寒战发生的比例Ⅰ组为57.5％、Ⅱ组为32.5％、Ⅲ组为17.5％,组间比较差异有统计学意义(P＜0.05)；Ⅱ组患者术中和苏醒期平均体温以及术后寒战发生的比例与Ⅲ组比较差异有统计学意义(P＜0.05). 结论 温灌洗液在PCNL中的应用可以有效减少围术期寒战的发生率,对患者呼吸、循环功能无显著影响,安全有效.
目的 探討溫灌洗液在經皮腎鏡取石術(pereutaneous nephrolithotripsy,PCNL)中的應用效果. 方法 120例全痳下PCNL患者,採用隨機數字錶法隨機分為3組(每組40例):Ⅰ組(室溫靜脈輸液和室溫灌洗液組)、Ⅱ組(室溫靜脈輸液和溫灌洗液組)、Ⅲ組(溫靜脈輸液和溫灌洗液組).各組均在室溫相同的條件下痳醉,統計靜脈輸液總量和灌洗液總量,同時記錄有創平均動脈壓(mean arterial pressure,MAP)、中心靜脈壓(central venous pressure,CVP)、圍術期平均體溫以及術後寒戰髮生的比例. 結果 Ⅰ、Ⅱ組患者囌醒期平均體溫低于術中平均體溫0.7℃左右,組內比較差異有統計學意義(P＜0.05)；Ⅲ組患者囌醒期與術中平均體溫相比變化不大,組內比較差異無統計學意義(P＞0.05).Ⅰ組患者術中及囌醒期平均體溫低于Ⅱ、Ⅲ組,術後寒戰髮生的比例Ⅰ組為57.5％、Ⅱ組為32.5％、Ⅲ組為17.5％,組間比較差異有統計學意義(P＜0.05)；Ⅱ組患者術中和囌醒期平均體溫以及術後寒戰髮生的比例與Ⅲ組比較差異有統計學意義(P＜0.05). 結論 溫灌洗液在PCNL中的應用可以有效減少圍術期寒戰的髮生率,對患者呼吸、循環功能無顯著影響,安全有效.
목적 탐토온관세액재경피신경취석술(pereutaneous nephrolithotripsy,PCNL)중적응용효과. 방법 120례전마하PCNL환자,채용수궤수자표법수궤분위3조(매조40례):Ⅰ조(실온정맥수액화실온관세액조)、Ⅱ조(실온정맥수액화온관세액조)、Ⅲ조(온정맥수액화온관세액조).각조균재실온상동적조건하마취,통계정맥수액총량화관세액총량,동시기록유창평균동맥압(mean arterial pressure,MAP)、중심정맥압(central venous pressure,CVP)、위술기평균체온이급술후한전발생적비례. 결과 Ⅰ、Ⅱ조환자소성기평균체온저우술중평균체온0.7℃좌우,조내비교차이유통계학의의(P＜0.05)；Ⅲ조환자소성기여술중평균체온상비변화불대,조내비교차이무통계학의의(P＞0.05).Ⅰ조환자술중급소성기평균체온저우Ⅱ、Ⅲ조,술후한전발생적비례Ⅰ조위57.5％、Ⅱ조위32.5％、Ⅲ조위17.5％,조간비교차이유통계학의의(P＜0.05)；Ⅱ조환자술중화소성기평균체온이급술후한전발생적비례여Ⅲ조비교차이유통계학의의(P＜0.05). 결론 온관세액재PCNL중적응용가이유효감소위술기한전적발생솔,대환자호흡、순배공능무현저영향,안전유효.
Objective To observe the effect to patients of applying lukewarm lavage fluid in percutaneous nephrolithotomy (PCNL).Methods 120 cases of undergoing PCNL patients who received general anesthesia and endotracheal intubation using random number table,were randomly divided into three groups(n=40).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 (MAP) and central venous pressure (CVP).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.Conclusions Lukewarm lavage can be effective in reducing the incidence of postoperative shivering in PCNL,without side effect to patient's perioperative circulatory function.
