目的： 探讨多模式保温措施对经皮肾镜取石术（PCNL）患者术中低体温和麻醉恢复质量的影响。方法： 选择择期行经皮肾镜取石术患者50例，随机分为对照组（C组）和多模式保温组（W组），每组25例。C组覆盖铺巾，术中静脉输液液体和灌洗液均为常温；W组采用充气式保温毯、输注液体和灌洗液加温等保温措施。C组记录患者麻醉前（T₀）、手术开始30 min（T₁）、手术开始60 min（T₂）、手术结束30 min（T₃）和60 min（T₄）的鼻咽温；观察两组患者恢复自主呼吸时间、呼之睁眼时间、意识清醒时间、拔管时间和Steward评分，记录在麻醉后监测治疗室（PACU）期间寒战的发生情况。结果： 与T₀比较，二组患者鼻咽温度均降低（P<0.01），与C组比较，W组T₁~T₄的鼻咽温度明显高于C组（P<0.05），W组患者恢复自主呼吸时间、呼之睁眼时间、拔管时间、意识完全清醒时间较C组缩短，Steward评分高于C组（P<0.05），W组寒战发生率低于C组（P<0.05）。结论： 在经皮肾镜取石术手术中，采取多模式保温措施可减少围术期低体温的发生，从而提高麻醉恢复质量，有利患者术后康复。

[1] MACARIO A,DEXTER F.What are the most important risk factors for a patient's developing intraoperative hypothermia?[J].Anesth Analg,2002,94(1):215.
[2] 刘丹,汪涛,何开华.老年患者全膝关节置换围术期不同输血输液温度对术后恢复质量的影响[J].临床麻醉学杂志,2016,32(2):122-125.
[3] CROSSLEY A W,MAHAJAN R P.The intensity of postoperative shivering is unrelated to axillary temperature[J].Anaesthesia,1994,49(3):205.
[4] Sessler D I.Perioperative heat balance[J].Anesthesiology,2000,92(2):578-596.
[5] KENJI H,CHIHARU N,FUMITOSHI N,et al.Core temperatures during major abdominal surgery in patients warmed with new circulating-water garment,forced-air warming,or carbon-fiber resistive-heating system[J].J Anesth,2012,26(2):168-173.
[6] SESSLER D I.Complications and treatment of mild hypothermia[J].Anesthesiology,2001,95(2):531-543.
[7] HOROSZ B,MALEC-MILEWSKA M.Methods to prevent intraoperative hypothermia[J].Anaesthesiol Intensive Ther,2014,46(2):96-100.
[8] JOHN M,FORD J,HARPER M.Peri-operative warming devices:performance and clinical application[J].Anaesthesia,2014,69(6):623-638.
[9] ANDRZEJOWSKI J C,TURNBULL D,NANDAKUMAR A,et al.A randomised single blinded study of the administration of pre-warmed fluid vs active fluid warming on the incidence of peri-operative hypothermia in short surgical procedures[J].Anaesthesia,2010,65(9):942-945.
[10] 高成顺,熊君宇.温灌洗液降低经皮肾镜取石术围术期寒战的发生率[J].国际麻醉学与复苏杂志,2013,34(8):684-686.
[11] LENHARDT R,MARKER E,GOLL V,et al.Mild intraoperative hypothermia prolongs postanesthetic recovery[J].Anesthesiology,1997,87(6):1318-1323.
[12] BUGGY D J,CROSSLEY A W A.Thermoregulation,mild perioperative hypothermia and postanesthetic shivering[J].Brit J Anaesth,2000,84(5):615-628.