摘要
目的:探讨经皮肾镜取石术(PCNL)中应用生理盐水灌注液所引起的老年患者血流动力学的变化。方法:PC-NL治疗上尿路结石的老年患者67例,检测手术前、后患者血液生化、血流动力学指标的改变。结果:术中平均生理盐水用量37.8L。与手术前相比,手术后红细胞压积(HCT)显著降低(P<0.05)。中心静脉压(CVP)显著升高(P<0.05),平均动脉压(MAP)、二氧化碳结合力(CO2CP)有下降趋势,心率(HR)有上升趋势,而手术前、后血钠(Na+)、钾(K+)、氯(Cl-)、肌酐(Cr)等均无显著性(P>0.05)。结论:PCNL中应用大量灌注液可引起循环超负荷,灌注液吸收可导致老年患者血生化、血流动力学指标的显著变化。
Objective： To explore the change of hemodynamics and blood biochemical markers of high pressure irriga- ting fluid on agedness patients who underwent percutaneous nephrolithotomy（PCNL）. Methods： In this study, 67 casez with upper urinary stones were treated with PCNL. The changes of blood biochemical markers and hemodyrmmics in a- gedness patients before and after surgery were inspected. Results：The average volume of irrigating fluid（0. 9 % NaCl） was 37. 8L. Compared with those before operation, post-operative central venous pressure（CVP） of patients increased significantly（P〈0. 05） ;hematocrit（HCT） decreased significantly（P〈0. 05）. There were mild decreased in plasma lev- els of carbon dioxide combining power （CO2 CP）, the mean arterial pressure （MAP） before and after surgery （P〉 0. 05）. There were mild increased in the heart rate（HR）, There were no significant differences in plasma levels of sodi- um（Na＋ ）, potassium（K＋ ）, chloridion（Cl- ）, creatinine（Cr）. Conclusion： Application of irrigating fluid during PCNL may induce blood absorption of irrigating fluid which increases the blood volume and circulation overload, the blood ab- sorption of irrigating solution may cause significant changes of blood biochemical and hemodynamic parameters in aged- ness patients.
出处
《医学理论与实践》
2012年第18期2207-2208,共2页
The Journal of Medical Theory and Practice
关键词
经皮肾镜取石术
血生化
血流动力学
循环超负荷
Percutaneous nephrolithotomy,Blood biochemical markers, Hemodynamics,Circulation overload
