CAJ | 학술논문

目的：观察经皮肾镜取石手术（PCNL）在不同灌注时间下灌洗液吸收对患者氧合指数及酸碱平衡的影响。方法择期全身麻醉下行 PCNL 患者40例，按照灌注时间分为两组：S 组，灌注时间＜120 min（n＝22）；L 组，灌注时间≥120 min （n＝18）。麻醉诱导后监测 CVP，灌注中每20分钟监测一次并记录灌注中最高值，术中检测灌注前后动脉血气分析并记录氧合指数、pH 及 BE值。结果两组患者灌注中 CVP 最高值 L 组明显高于 S 组（P＜0.05），灌注后 L 组氧合指数明显低于灌注前（P＜0.05），灌注前后 L 组氧合指数差值明显大于 S 组（P＜0.05）。灌注后 L 组 pH 及 BE值均明显低于 S 组（P＜0.05）。结论PCNL 长时间灌注有导致肺氧合功能下降，代谢性酸中毒的风险，术中应适当缩短灌注时间。
목적：관찰경피신경취석수술（PCNL）재불동관주시간하관세액흡수대환자양합지수급산감평형적영향。방법택기전신마취하행 PCNL 환자40례，안조관주시간분위량조：S 조，관주시간＜120 min（n＝22）；L 조，관주시간≥120 min （n＝18）。마취유도후감측 CVP，관주중매20분종감측일차병기록관주중최고치，술중검측관주전후동맥혈기분석병기록양합지수、pH 급 BE치。결과량조환자관주중 CVP 최고치 L 조명현고우 S 조（P＜0.05），관주후 L 조양합지수명현저우관주전（P＜0.05），관주전후 L 조양합지수차치명현대우 S 조（P＜0.05）。관주후 L 조 pH 급 BE치균명현저우 S 조（P＜0.05）。결론PCNL 장시간관주유도치폐양합공능하강，대사성산중독적풍험，술중응괄당축단관주시간。
Objective To investigate the impact of different irrigation time on oxygenation in-dex and acid-base balance during percutaneous nephrolithotomy(PCNL).Methods Forty patients un-dergoing selective PCNL were included in this study,were divided into two groups:group S,irrigation time<120 min(n=22);group L,irrigation time≥120 min(n=18).PaO2/FiO2 ,pH and BE were determined before and after irrigation,CVP were recorded before irrigation and every 20 min during irrigation. Results The CVP maximum value were higher in group L than that in group S during irrigation (P <0.05).The PaO2/FiO2 were lower after irrigation than that before irrigation in group L(P<0.05).The pH and BE were lower in group L than that in group S after irrigation(P<0.05).Conclusion Irrigation fluid absorption is observed during PCNL.That can provoke oxygenation function decline and metabolic ac-idosis with irrigation time extend,the operation time properly shortened.