冲洗液温度对前列腺等离子电切术患者围术期体温及血液流变学的影响

目的 比较经尿道前列腺等离子电切术(plasmakinetic resection of prostate,PKRP)采取不同温度冲洗液对患者体温及血液流变学的影响.方法 选择60例拟行PKRP的老年患者,ASA Ⅰ ～Ⅲ级,选择L2-3间隙行腰-硬椎管内联合麻醉.冲洗液为0.9％氯化钠溶液,按照术冲洗液温度随机表法将...

Effects of irrigation fluid temperature on patients' body temperature and hemorheology during perioperative period of PKRP

Objective To compare the effects of irrigation fluid temperature on patients' body temperature and hemorheology during transurethral plasmakinetic resection of prostate(PKRP).Methods 60 ASA Ⅰ -Ⅲ elderly patients scheduled for PKRP were selected for the study,L2-3 combined spinal-epidural anesthesia was applied.0.9％ sodium chloride solution was chosen as the irrigation fluid.The patients were randomly divided into two groups by different temperature of irrigation fluid.There were 30 patients in each group.Group Ⅰ used the irrigation fluid of room temperature; while group Ⅱ used the fluid of 37℃.The patients' rectal temperature,blood pressure,and heart rate were recorded,and hemoglobin (Hb),hematocrit (Hct),indicators of plasma electrolytes and hemorheology were measured by extracting venous blood at time points of before operation (T0),at the end of operation (T1),6 h after operation (T2) and 24 h after operation (T3).Results The temperature of the patients after operation in group Ⅰ was significantly lower than that before surgery (35.3±0.3)℃ vs (36.7±0.1)℃,P＜0.05)],while group Ⅱ displayed no significant changes.There were no significant changes of electrolytes in both of the two groups.Hematocrit changed in different degrees.The whole blood viscositygroup Ⅰ (4.88±0.77),(4.12±0.34); Ⅱ group(4.92±0.66),(4.34±0.43)]and reduction viscosity group Ⅰ (6.75±0.92),(6.34±2.67); group Ⅱ (6.78±0.81),(6.63±1.95)]were reduced in both groups,but significantly increased 24 h after operation in group Ⅰ (5.28±0.22),(7.99±0.89);(1.96±0.18)].Conclusion The temperature of irrigation fluid can cause changes of patients' body temperature and hemorheology during PKRP.Hypothermia can increase blood viscosity after surgery.