大椎穴督灸贴预防PKRP、输尿管镜下激光碎石手术围术期低体温疗效观察  

Medicated plaster at Dazhui(GV 14)for preventing perioperative hypothermia in patients undergoing PKRP and ureteroscopic laser lithotripsy

作　　者：于桂杰[1] 汪静 宋伟[1] 周亚兰 吴晓珲[1] 郭君[1] 王剑[1] YU Gui-jie;WANG Jing;SONG Wei;ZHOU Ya-lan;WU Xiao-hui;GUO Jun;WANG Jian(Department of Anesthesiology,Shuguang Hospital Affiliated to Shanghai University of TCM,Shanghai 200021,China)

机构地区：[1]上海中医药大学附属曙光医院麻醉科,上海200021

出　　处：《中国针灸》2020年第10期1067-1070,1075,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金(青年科学基金)项目:81603700。

摘　　要：目的:观察行大椎穴督灸贴对等离子前列腺电切术(PKRP)、输尿管镜下激光碎石术患者围术期低体温的预防效果。方法:选择美国麻醉医师协会(ASA)分级为Ⅰ级或Ⅱ级,择期在全凭静脉麻醉(TIVA)下行输尿管镜下钬激光碎石术/PKRP患者300例,随机分为观察组和对照组,每组150例。对照组采用常规棉被覆盖的保温措施;观察组在对照组基础上,术前30 min于大椎穴贴敷督灸药包。记录患者围术期(入手术室后术前静息状态时、手术5 min、手术10 min、术毕时、术后5 min、术后10 min)各时间点的体温(耳温)、平均动脉压(MAP)、心率、血氧饱和度(SpO2),记录低体温发生例数、术后寒战程度分级,及手术时间、丙泊酚用量、术中输液量、术中冲洗液量。结果:在手术5 min、手术10 min、术毕时,两组患者体温均低于术前及前一个时间点(P<0.01);在术后5 min、术后10 min,两组患者体温均高于前一个时间点(P<0.01),但仍低于术前体温(P<0.01);在手术10 min、术毕时、术后5 min、术后10 min,观察组体温均高于对照组(P<0.01,P<0.05)。观察组低体温总发生率为2.0%(3/150),明显低于对照组的13.3%(20/150,P<0.01)。观察组、对照组术后总寒战率分别为18.0%(27/150)、28.7%(43/150,P>0.05)。结论:督灸贴敷大椎穴应用于PKRP、输尿管镜下激光碎石术能有效预防围术期低体温,提升患者的体感舒适度。Objective To observe the preventive effect of medicated plaster at Dazhui(GV 14)on preventing perioperative hypothermia in patients undergoing plasmakinetic resection of prostate(PKRP)and ureteroscopic laser lithotripsy.Methods A total of 300 patients with ASA gradeⅠorⅡreceiving ureteroscopic laser lithotripsy or PKRP under total intravenous anesthesia(TIVA)were randomly divided into an observation group and a control group,150 cases in each group.The patients in the control group received routine heat preservation measures,while on the basis of the control group,the patients in the observation group were treated with medicated plaster at Dazhui(GV 14)30 min before operation.The temperature(ear temperature),mean arterial pressure(MAP),heart rate and blood oxygen saturation(SpO2)at each time point(resting state before operation,5,10 min into operation,at the end of operation,5 and 10 min after operation)were recorded;the number of hypothermia,the classification of postoperative shivering degree,operation time,propofol dosage,intraoperative infusion volume and intraoperative flushing fluid volume were recorded.Results The temperature at 5 and 10 min into operation as well as at the end of operation in the two groups was all lower than that before operation and at previous time point(P<0.01).The temperature at 5 and 10 min after operation in the two groups was all higher than that at previous time point(P<0.01),but still lower than that before operation(P<0.01).The temperature at 10 min into operation,at the end of operation,5 and 10 min after operation in the observation group was higher than that in the control group(P<0.01,P<0.05).The total incidence rate of hypothermia in the observation group was 2.0%(3/150),which was significantly lower than 13.3%(20/150)in the control group(P<0.01).The total incidence rate of shivering was 18.0%(27/150)in the observation group and 28.7%(43/150)in the control group(P>0.05).Conclusion The medicated plaster at Dazhui(GV 14)can effectively prevent perioperative hypothermia an

关 键 词：等离子前列腺电切术(PKRP) 输尿管镜下激光碎石术 低体温 督灸 穴 大椎 

分 类 号：R246.2[医药卫生—针灸推拿学]