摘要
目的探讨充气式保温毯上半身加温对侧卧位胸腔镜手术患者术中低体温的干预效果,为侧卧位胸腔镜手术患者术中加温方式的选择提供参考。方法将南京医科大学第一附属医院江苏省人民医院2018年12月至2019年7月收治的82例行侧卧位胸腔镜手术患者,按照随机数字表法分为上半身组和下半身组,每组41例。上半身组将一次性加温毯覆盖于患者的颈后部、背部和两臂,注意避开手术区域,下半身组将一次性加温毯覆盖于髂嵴至双足之间。分别于入室时、麻醉插管时、手术开始时、手术30 min、手术60 min、手术90 min、手术120 min以及手术结束时测量患者核心体温,比较2组患者术中低体温发生率及离室时生命体征。结果手术开始时、手术30 min、手术60 min、手术90 min时上半身组核心体温分别为(36.70±0.12)、(36.65±0.16)、(36.30±0.18)、(36.32±0.19)℃,高于下半身组的(36.42±0.13)、(36.32±0.17)、(36.17±0.14)、(36.21±0.15)℃,差异有统计学意义(t值为2.743~10.362,P<0.05);2组患者其余时段核心体温差异无统计学意义(P>0.05)。上半身组术中低体温发生率和术后寒战发生率分别为12.2%(5/41)和4.9%(2/41),低于下半身组的31.7%(13/41)和21.9%(9/41),差异有统计学意义(χ2值为4.556、5.145,P<0.05)。2组患者其余术后并发症及离室时生命体征指标比较差异无统计学意义(P>0.05)。结论充气式保温毯上半身加温法维持胸腔镜手术患者核心体温的效果更好,低体温和寒战发生率更低。
Objective To explore the prevention effect of forced-air warming to the upper body on hypothermia during thoracoscopic surgery in the lateral decubitus position.Methods A total of 82 patients undergoing thoracoscopic surgery in the lateral position from December 2018 to July 2019 in Jiangsu People's Hospital,the First Affiliated Hospital of Nanjing Medical University were divided into upper body group and lower body group according to the random number table method.Each group was 41 cases.Patients received forced-air warming on the upper body or lower body in the upper body group and lower body group,respectively.The bladder temperature was measured as core temperature at operation room,intubation,start of the surgery,30 min after surgery,60 min after surgery,90 min after surgery,120 min after surgery,end of the surgery.The incidence of intraoperative hypothermia,perioperative adverse complications and vital index at leaving the room were compared between upper body group and lower body group.Results The core temperature at start of the surgery,30 min after surgery,60 min after surgery,90 min after surgery were(36.70±0.12),(36.65±0.16),(36.30±0.18),(36.32±0.19)℃in the upper body group,and(36.42±0.13),(36.32±0.17),(36.17±0.14),(36.21±0.15)℃in the lower body group,the differences were statistically significant(t values were 2.743-10.362,P<0.05).However,there was no statistically significant in the core temperature at other time points between the two groups(P>0.05).The incidences of intraoperative hypothermia and perioperative shiver were 12.2%(5/41),4.9%(2/41)in the upper body group,and 31.7%(13/41),21.9%(9/41)in the lower body group,the differences were statistically significant(χ2 values were 4.556,5.145,P<0.05).There was no statistically significant in the other perioperative adverse complications and vital index at leaving the room between two groups(P>0.05).Conclusions Forced-air warming was more effective on the upper body in resistive body core temperature.Besides,the incidences of hypothermia
作者
葛经武
杜祥飞
乔玫
Ge Jingwu;Du Xiangfei;Qiao Mei(Department of Operating Room,Jiangsu People's Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210009,China)
出处
《中国实用护理杂志》
2021年第10期733-738,共6页
Chinese Journal of Practical Nursing
关键词
核心体温
低体温
充气式加温毯
胸腔镜手术
Core temperature
Hypothermia
Forced-air warming blanket
Thoracoscopic surgery
