摘要
目的观察术中适时调温及常规保温策略对全麻双膝关节置换手术患者术中体温的影响,为低体温高风险人群探寻一种安全、有效的体温管理方法。方法选择全麻下行同期双膝关节置换手术患者98例,随机均分为观察组和对照组各49例。对照组采用常规被动保温和冲洗液加温措施;观察组采用术中适时调温策略。分别收集入室后、麻醉诱导后、手术开始时、手术40min、手术80min、手术120min、出室时的体温、术中出血量、麻醉苏醒时间和术后寒战情况。结果两组体温均随着手术进程逐渐降低,对照组降幅更大,两组比较组间效应、时间效应、交互效应均P<0.01。观察组观察期内低体温状况、麻醉恢复时间、寒战发生率与对照组比较,差异有统计学意义(均P<0.01)。两组术中出血量比较差异无统计学意义(P>0.05)。结论术中适时调温策略有利于提高全麻双膝关节置换手术中的体温值,降低低体温和寒战发生率,缩短麻醉苏醒时间。
Objective To observe the effect of timely temperature-adjustment strategy versus routine heat preservation strategy on body temperature in patients undergoing bilateral total knee arthroplasty under general anesthesia,and to explore a safe and effective temperature management method for patients at high-risk of hypothermia.Methods Totally,98 patients undergoing bilateral total knee arthroplasty under general anesthesia were selected and evenly randomized into 2 groups.The timely temperature-adjustment strategy was applied in the intervention group,while routine heat preservation strategy was applied in the control group.Body temperature data were collected respectively at the time points of entry into the operating room,immediately after anesthesia induction,at the beginning of the operation,40 mins,80 mins,120 mins into the operation,exit from the room.Bleeding volume,the time to emerge from anesthesia and incidence rate of postoperative shivering were also recorded.Results Patients′body temperatures in both groups decreased gradually as the surgery proceeded on,and the reduction in the control group was greater.The group effects,time effects and group-by-time effects of body temperature data over time were significant(P<0.01 for all).The distribution of hypothermia,the time to emerge from anesthesia and incidence rate of postoperative shivering in the 2 groups had significant differences(P<0.01 for all).There was no statistical difference in bleeding volume during the operation between the 2 groups(P>0.05).Conclusion The timely temperature-adjustment strategy improves patients′temperature levels during total knee arthroplasty,and reduces the incidence rate of hypothermia and postoperative shivering,and shortens the time to emerge from anesthesia.
作者
辛海峰
田小荣
李琼
李永新
康宏
Xin Haifeng;Tian Xiaorong;Li Qiong;Li Yongxin;Kang Hong(Operating Room,The Second Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《护理学杂志》
CSCD
北大核心
2019年第21期42-44,48,共4页
Journal of Nursing Science
关键词
全膝关节置换术
低体温
寒战
适时调温策略
主动保温
被动保温
total knee arthroplasty
hypothermia
shivering
timely temperature-adjustment strategy
active temperature preservation
passive temperature preservation
