不同温度灌洗液对输尿管软镜下钬激光碎石术后寒战及炎性反应的影响分析  

Effect of different temperature lavage fluid on shivering and inflammatory response after ureteral holmium laser lithotripsy

作　　者：辛锋[1] 刘久华[1] 范利[1] Xin Feng;Liu Jiuhua;Fan Li(Department of Urology,the Second People′s Hospital of Lianyungang,Lianyungang 222006,China)

机构地区：[1]连云港市第二人民医院泌尿外科,连云港222006

出　　处：《国际外科学杂志》2024年第1期43-48,共6页International Journal of Surgery

基　　金：江苏省连云港市卫生计生科技项目(201818)。

摘　　要：目的探讨等体温(37℃)、等室温(24℃)及冷液体(20℃)3种温度的灌洗液对输尿管软镜下钬激光碎石术后寒战及炎性反应的影响。方法选取连云港市第二人民医院2020年7月—2023年7月收治的132例接受输尿管软镜下钬激光碎石术患者的病历资料,根据术中灌洗液温度分为冷液体组(20℃,n=44)、等室温组(24℃,n=44)和等体温组(37℃,n=44),采用方差分析三组手术10 min、30 min、术毕即刻核心体温、手术前后应激反炎性反应,采用χ2检对比三组术后寒战发生情况。结果三组患者手术10 min、30 min、术毕即刻核心体温对比差异具有统计学意义,冷液体组上述时间点核心体温较等室温组、等体温组低(P<0.05),而等室温组和等体温组术中10 min、30 min、术毕即刻核心体温对比差异无统计学意义(P>0.05);三组术后甲肾上腺素、血清皮质醇水平较术前升高,冷液体组较等室温组和等体温组高(P<0.05),但等室温组和等体温组两组术后对比差异无统计学意义(P>0.05);三组术后C反应蛋白、白细胞介素-10、白细胞水平较术前升高,但各组间术后对比差异无统计学意义(P>0.05);三组术后寒战发生率对比差异具有统计学意义(χ^(2)=6.87,P=0.030),术后冷体液组寒战发生9例,寒战发病率最高为20.45%,等室温组寒战3例,等体温组寒战2例,寒战发病率(6.81%比4.55%)对比差异无统计学意义(P>0.05)。结论在输尿管软镜下钬激光碎石术中,与冷液体灌洗液相比,术中采用等室温灌洗液和等体温灌洗液能维持患者术中体温恒定,减轻应激反应,术后炎性反应轻且术后寒战发生率低。Objective To investigate the effects of constant body temperature(37℃),constant room temperature(24℃)and cold liquid(20℃)on shivering and inflammatory response after holmium laser lithotripsy under ureteroscope.Methods A total of 132 patients receiving holmium laser lithotripsia under ureteroscope treated in the Second People′s Hospital of Lianyungang City from July 2020 to July 2023 were selected as the study objects.According to the intraoperative lavage fluid temperature,they were divided into cold liquid group(20℃,n=44),equal room temperature group(24℃,n=44)and equal body temperature group(37℃,n=44)..Anova was used to compare the occurrence of postoperative chills in the three groups at 10 min,30 min,immediately after the operation,and the anti-inflammatory response of stress before and after the operation.Chi-square test was used to compare the occurrence of postoperative chills.Results The difference of core body temperature between the three groups at 10 min,30 min and immediately after operation was statistically significant.The core body temperature of the cold liquid group was lower than that of the equal room temperature group and the equal body temperature group at the above time point(P<0.05).There was no significant difference in core body temperature between the isoroom temperature group and the isobody temperature group at 10 min,30 min and immediately after operation(P>0.05)..The levels of norepinephrine and serum cortisol in the three groups were higher after surgery than before surgery,and the levels in the cold liquid group were higher than those in the isothermal group and the isothermal group(P<0.05),but there was no statistical significance between the isothermal group and the isothermal group(P>0.05).The levels of C-reactive protein,interleukin-10 and white blood cells were higher after operation than before operation,but there was no statistical significance among the three groups(P>0.05).There was a statistically significant difference in the incidence of postoperative chil

关 键 词：温度 碎石术 激光 寒战 输尿管软镜 

分 类 号：R699[医药卫生—泌尿科学]