经皮肾镜取石术围手术期血液流变学变化

目的探讨经皮肾镜取石术（PCNL）患者围手术期的管理,为临床治疗提供理论依据。方法对40例上尿路结石患者择期行PCNL。于术前（T1）、术中（T2）、术毕（T3）和术后（T4）分别抽取静脉血液,检测血液流变学各项指标。结果 40例手术均顺利完成。将T3、T4与T1进行比较,低切还原黏度、中切还原黏度、低切黏度、血浆黏度显著升高（P〈0.05）;将T2、T3、T4与T1进行比较,红细胞刚性指数增高,变形指数显著下降。结论应加强对PCNL围手术期血液流变学指标的监测,降低血液黏度,保护红细胞,减少心血管事件及深静脉血栓发生。

Hemorheological exchange during peroperative period of percutaneous nephrolithotomy

Objective To investigate the management of perioperative percutaneous nephrolithotomy and provide a theoretical basis for clinical treatment.Methods 40 cases of upper urinary tract calculi treated with elective PCNL.And preoperation（T1）,intraoperation（T2）,immediate after surgery（T3）,postoperative 4h（T4） was extracted from venous blood test hemorheological parameters.Results 40 cases were successfully completed.low shear reduced viscosity,reduced viscosity cut low viscosity,plasma viscosity was significantly higher（P〈0.05） which T3,T4 compared with T1,T2,T3,T4 and T1 comparison,increased erythrocyte rigidity index,deformation The index fell significantly decreased.Conclusion We should strengthen the monitoring the hemorheology perioperative during PCNL,reduce blood viscosity,protect red blood cells,reducing the occurrence of cardiovascular events,and deep vein thrombosis.