摘要
目的观察将充气式加温毯设置为不同温度为先天性髋关节脱位手术患儿进行术中保温对患儿术中生命体征、炎症因子变化及术后康复的影响。方法选择全麻下行髋关节脱位矫形术患儿39例,随机分为32℃组、38℃组和43℃组,将充气式加温毯分别设置为相应温度对患儿进行保温。于麻醉诱导插管后即刻(T0)、手术切皮时(T1)、手术开始后1 h(T2)、手术开始后2 h(T3)和手术结束时(T4)5个时间点记录3组的体温及其他生命体征。于T0和T4时间点取血测定TGF-β活化情况、TNF-α、IL-1β和IL-10含量。结果与T0时刻相比,3组T1至T4时间点体温升高(P<0.05),且在正常范围内,38℃组术中体温保持最为平稳。与32℃组和43℃组相比,38℃组在T4时间点血清内TNF-α和IL-1β含量显著降低,而TGF-β和IL-10含量显著升高(P<0.05)。43℃组术后发热例数多于另外两组,差异具有统计学意义(P<0.05)。结论充气式加温毯设置为32℃、38℃和43℃均能保证术中患儿生命体征平稳,纠正患儿术前及麻醉诱导过程中的低体温。采用38℃的气体充气毯加温更有利于术中维持患儿体温平稳,有效抑制机体炎症反应。
Objective To observe influences of thermal insulation at different temperatures on changes of vital signs ,and inflammatory factors in children with congenital dislocation of the hip joint during surgery and postopera- tive rehabilitation. Methods Totally 39 cases of children undergoing congenital dislocation hip surgery under gen- eral anesthesia were selected and randomly divided into 32℃ ,38℃ and 43℃ groups. Children patients in three groups were given forced air heating at 32℃,38℃ and 43℃ ,respectively. The body temperature and other vital signs of each group were recorded immediately after anesthesia induction and intubation （To）,during surgical biopsy （Tx）,at lh after operatiou（T2）,2 h after operation（T3） and at the end of operation（T,）. The venous blood was tak- en at To and T4 to determine the serum TGF-β activation,TNF-α,IL-1β and IL-10. Results Compared with T0,the temperature of three groups increased at T1-4 （P〈0.05）,and 38℃ group had the most reliable temperature mainte- nance. Compared with 32℃ and 43℃ groups,serum TNF-α and IL-1β significantly decreased and TGF-β and IL-10 significantly increased in 38℃ group at T4（P〈0.05）. Children in 43℃ group developed more eases of fever com- pared with other two groups,and the difference was significant （P〈0.05）. Conclusion Temperatures setting at 32℃, 38℃ and 43℃ can guarantee stable vital signs during surgery,and address hypothermia before surgery and during anesthesia induction. Applying 38℃ gas heating can maintain normal intra-operative body temperature and effectively inhibit inflammatory response.
出处
《中华护理杂志》
CSCD
北大核心
2017年第9期1047-1051,共5页
Chinese Journal of Nursing
关键词
体温
炎症因子
转化生长因子-Β
先天性髋关节脱位手术
康复
Body Temperature
Inflammatory Factor
Transforming Crowth Factor Beta （TCF-13）
Congenital Hip Dislocation Operation
Rehabilitation
