Department of Urology, Suining Central Hospital, No. 127 Desheng W. Rd., Chuanshan District, Suining City, 629000, Sichuan Province, People's Republic of China.
Department of Urology, Institute of Urology, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu City, 610041, Sichuan Province, People's Republic of China.
BMC Urol. 2021 Apr 27;21(1):72. doi: 10.1186/s12894-021-00841-4.
Flexible ureteroscopic holmium laser lithotripsy is used to treat urinary tract calculi, but postoperative complications include shivering, fever and infection. To investigate the effects of irrigation fluid temperature on postoperative complications.
This randomized controlled trial included 120 consecutive patients undergoing flexible ureteroscopic holmium laser lithotripsy at the Urology Department, Suining Central Hospital, Sichuan, China between January 2017 and July 2019. Patients were randomized 1:1:1 into three groups (17 °C, 27 °C or 37 °C). Primary outcome was fever incidence (body temperature > 37.5 °C) within 48 h after surgery. Secondary outcomes included shivering incidence during recovery from anesthesia, white blood cell count (WBC), serum procalcitonin (PCT) and incidence of suspected infection (temperature > 38.5 °C and PCT > 0.5 µg/L).
There were 108 patients, (17 °C group, n = 36; 27 °C group, n = 35; 37 °C group, n = 37), received flexible ureteroscopic holmium laser lithotripsy and analyzed. Age, gender distribution, body mass index, ASA grade, stone burden, preoperative creatinine, preoperative core temperature and irrigation fluid volume did not differ significantly between groups. 17 °C, 27 °C and 37 °C groups exhibited significant differences in the incidences of postoperative fever (38.9% vs. 17.1% vs. 13.5%) and shivering (22.2% vs. 5.7% vs. 2.7%) (p < 0.05 for all pairwise comparisons). There was no significant difference of WBC, PCT and incidence of suspected infection in 37 °C or 27 °C group compared with 17 °C group. One case each of flash pulmonary edema and bleeding occurred in 37 °C group.
Warming the irrigation fluid can reduce the incidence of postoperative fever and shivering, but further studies are needed to determine the optimal temperature. Trial registration The trial was registered at the Chinese Clinical Trials Registry and allocated as ChiCTR2000031683. The trial was registered on 07/04/2020 and this was a retrospective registration.
软性输尿管镜钬激光碎石术用于治疗尿路结石，但术后并发症包括寒战、发热和感染。本研究旨在探讨灌洗液温度对术后并发症的影响。
本随机对照试验纳入了 2017 年 1 月至 2019 年 7 月期间在中国四川省遂宁市中心医院泌尿科接受软性输尿管镜钬激光碎石术的 120 例连续患者。患者按 1:1:1 的比例随机分为三组（17°C、27°C 或 37°C）。主要结局为术后 48 小时内发热（体温>37.5°C）的发生率。次要结局包括麻醉恢复期寒战的发生率、白细胞计数（WBC）、血清降钙素原（PCT）和疑似感染的发生率（体温>38.5°C 和 PCT>0.5μg/L）。
108 例患者（17°C 组，n=36；27°C 组，n=35；37°C 组，n=37）接受了软性输尿管镜钬激光碎石术，并进行了分析。三组患者的年龄、性别分布、体重指数、ASA 分级、结石负荷、术前血肌酐、术前核心温度和灌洗液量无显著差异。术后 17°C、27°C 和 37°C 组的发热（38.9% vs. 17.1% vs. 13.5%）和寒战（22.2% vs. 5.7% vs. 2.7%）发生率差异有统计学意义（所有两两比较均 P<0.05）。与 17°C 组相比，37°C 组或 27°C 组的 WBC、PCT 和疑似感染发生率无显著差异。37°C 组各有 1 例发生急性肺水肿和出血。
加热灌洗液可降低术后发热和寒战的发生率，但需要进一步研究确定最佳温度。
该试验在中国临床试验注册中心注册，注册号为 ChiCTR2000031683。该试验于 2020 年 7 月 4 日注册，为回顾性注册。
