| Objectives This article aimed to find the effection made by expansion of fluid infusion of nursing intervention for the blood pressure pulse selffeeling (such as nausea, vomiting, shivering, etc) of mPCNL operation patients. To find the best results of expansion of fluid infusion treatment to the patients with mPCNL before lithotomy position changing into prone position. This study is designed to determine the safe period for antibiotic administration before the mPCNL operation on the basis of the changes of circulation and respiration, the feelings (such as nausea, vomiting, shivering, etc) of the patient and the administration of pressor agents. We also wanted find the optimal effects of venous expansion of fluid infusion before the alteration from lithotomy position to prone postion,which would ensure the stability of vital signs and the least adverse effects.Methods 160 subjects under the mPCNL were divided into four groups (observed group A,B, controlled groupC,D). All the four groups of patients apply the antibiotics and change the bladder lithotomic position into prone position when their vital signs are stale, and expand fluid infusion before surgery in the intervention of expansion of fluid replacement (the patient would establishment of venous administration routes→within 20 minutes after the anesthesia):Group A and B sufficiently complement physiological and pathological demand; Group C and D complement that half. Group A:antibiotics are administrated 20 minutes (including 20 minutes) after the physiological and pathological requirements completely compensated and anesthetic plane fixed; Group B:antibiotics are administrated within 20 minutes(10 to 15minutes after the anesthesia) after the physiological and pathological requirements completely compensated and anesthetic plane fixed; Group C:antibiotics are administrated 20 minutes later when the physiological and pathological requirements compensated in half and anesthetic plane fixed; Group D:antibiotics are administrated in 20 minutes after the physiological and pathological requirements half compensated and anesthetic plane fixed.Vital signs were measured before anesthetization and 5 minutes after anesthetization, before antibiotic administration and 2 minutes later, before lithotomy position, before prone position and 2 and 10 minutes later. The malaise feeling of the patients and the administration of pressor agents were also recored.All datd staticsed by spss13.0.Results There was no significant difference in the blood pressure before anesthetization and before antibiotic administration and before prone position among the four groups. The blood pressure of Group C and D was significantly lower than that of Group A and B (P<0.05) 5 minutes after anesthetization,2 min after antibiotic administration, before lithotomy position, and 2 min after prone position. And patients of Group A and B used less step-up drugs than patients of Group C and D(P<0.05). The increase of heart rate of Group D was significantly greater than that of Group B (P<0.05) 2 min after prone position. Nausea of Group A and B was significantly less than that of Group C and D (P<0.05) 2 min after prone position and after antibiotic administration. Vomit of Group A and B was significantly less than that of Group C and D (P<0.05) 2 min after prone position. The malaise feeling of most patients of Group A and B disappeared after infusing faster and stopping antibiotic administration. However, only a part of patients of Group C and D feeling better after stopping antibiotic administration and corresponding treatment. The recovering effects of Group C and D were not so good than that of Group A and B. There was no significant difference in the Oxygen saturation and shivering among the four groups(P>0.05).conclusions1. Complementing the physio-pathological requisite amount in the intervention of expansion of fluid replacement. After using up the antibiotics, patients change the bladder lithotomic position into prone position. Thus, there is little side effect on the patients and the adverse reactions are lightest. 2. It is the best way to begin using antibiotics 20 minutes after the anesthesia and having used fluid infusion to complement the physio-pathological requisite amount.3. Before changing into prone position, the best interference Can reduce the adverse reaction of patients in the perioperative period, improve the comfortableness of the patients and the mesatisfaction to the surgery, and reduce the dical costs. |
