【摘要】 目的探讨温盐水对高危老年患者行经尿道前列腺等离子电切术中进行冲洗的作用。方法回顾性研究2019年10月至2020年3月本院60例高危高龄经尿道前列腺等离子电切术患者的临床资料。按术中膀胱冲洗液温度不同,分为温水组(30例)和常温组(30例)。麻醉方式均为腰硬联合麻醉,常温组30例,平均年龄71.9岁,平均病史6.5年,平均前列腺体积76.5 ml,超声检查患者的平均残余尿81.2 ml,术中使用与室温相同温度(22℃)生理盐水进行冲洗。温水组30例,平均年龄75.4岁,平均病史6.7年,平均前列腺体积68.7 ml,超声检查患者的平均残余尿78.4 ml,术中使用等体温(37℃)生理盐水进行冲洗。比较两组的生命体征,术中、术后寒颤发生率、术后体温下降值、术中发生一过性低血压的例数、术后膀胱痉挛的发生率等指标。结果两组患者的年龄、前列腺体积、手术时间等基线资料差异均无统计学意义(P>0.05)。温水组与常温组患者术中寒颤发生率分别为(3.3%vs 20.0%),术后体温下降平均值[(1.0±0.2)℃vs (1.7±0.5)℃],膀胱痉挛的发生率(13.3%vs 40.0%),术后住院时间[(3.5±0.6)d vs (5.5±0.8)d],均低于常温组,差异有统计学意义(P<0.05)。温水组术前、术毕生命体征变化差异无统计学意义(P>0.05),常温组患者术前、术毕生命体征变化显著(P<0.001)。结论在高危经尿道前列腺等离子电切术患者术中使用37℃温生理盐水进行膀胱灌洗,可以减少生命体征的波动和围手术期并发症发生率,有利于患者术后快速康复。更多还原

【Abstract】 Objective To investigate the effect of warm water on the high-risk elderly patients undergoing transurethral plasmakinetic resection of the prostate(PKRP). Methods From October 2019 to March 2020, The clinical data of 60 high-risk elderly patients undergoing PKRP of the prostate with plasma electrotomy were analyzed retrospectively. According to the temperature of bladder irrigation fluid during operation, all patients were divided into warm water group(30 cases) and normal temperature group(30 cases). The anesthesia methods were combined with lumbar and hard anesthesia. In the normal temperature group, the average of age was 71.9 years, medical history was 6.5 years, the prostate volume was 76.5 ml, and the residual urine was 81.2 ml. In the warm water group, the average of age was 75.4 years, medical history was 6.7 years, the prostate volume was 68.7 ml, and the residual urine was 78.4 ml. The vital signs, intraoperative and postoperative tremor incidence, postoperative body temperature drop, intraoperative transient hypotension, and postoperative bladder spasm were compared. ResultsThere were no significant differences in baseline data such as age, prostate volume, and operation time between the two groups(P>0.05). The incidences of intraoperative chills in the warm water group and the normal temperature group were 3.3%, 20.0%, respectively, and the average postoperative temperature drop(1.0±0.2)℃,(1.7± 0.5)℃, the incidence of bladder spasm 13.33%, 40.0%, postoperative hospital stay(3.5±0.6) d, were lower than the normal temperature group(5.5±0.8) d, the differences were statistically significant(P<0.05). The changes of vital signs before and after the operation in the experimental group were not statistically significant(P>0.05), and the changes of vital signs before and after the operation in the control group were significant(P<0.001). Conclusion In the high-risk patients of PKRP, the use of 37℃ warm saline for bladder irrigation can reduce the fluctuation of vital signs and the incidence of perioperative complications, which is conducive to the rapid recovery of patients after surgery.更多还原