摘要
目的观察液体加温复合充气式加温毯的保温模式对下颌骨肿瘤切除术患者围术期体温及术后恢复质量的影响。方法将85例行全身麻醉下颌骨肿瘤切除术的患者随机分为A组(液体加温组,27例)、B组(充气式加温毯组,28例)和C组(液体加温复合充气式加温毯组,30例),各组采用相应的保温方式对患者进行保温。比较3组患者的围术期不同时间点[麻醉诱导前(T_(0))、手术开始后1 h(T_(1))、手术开始后2 h(T_(2))、手术开始后3 h(T_(3))、手术开始后4 h(T_(4))、手术开始后5 h(T_(5))、术毕时(T_(6))、出麻醉恢复室(PACU)时(T_(7))]的鼻腔体温,拔管所需时间、PACU滞留时间、热舒适度得分,以及术后躁动、低体温及寒战的发生率;术后24 h采用术后恢复质量量表(QoR-40)评价两组患者的术后恢复质量。结果3组患者围术期体温均呈先降低后升高的变化趋势,C组于T_(2)开始出现体温下降,而其他两组于T_(1)即开始出现;C组患者的体温在T_(1)~T_(7)时均于高于A、B两组患者(均P<0.05)。与A、B两组相比较,C组拔管所需时间、PACU滞留时间更短,术后寒战、躁动及低体温的发生率更低,术后热适度更高(均P<0.05)。术后24 h,C组QoR-40的身体舒适度得分、情绪状态得分、疼痛得分及总分均高于A、B两组(均P<0.05)。结论与单一措施相比,液体加温联合充气式加温毯的保温模式可更有效地维持行下颌骨肿瘤切除术患者围术期的核心体温,降低患者术后低体温、寒战及躁动的发生率,提高患者热舒适度及术后恢复质量。
Objective To observe the effect of thermal insulation mode of liquid heating combined with inflatable warming blanket on perioperative body temperature and postoperative recovery quality in patients undergoing mandibular tumor resection.Methods Eighty-five patients undergoing mandibular tumor resection under general anesthesia were randomly divided into group A(liquid heating group,27 cases),group B(inflatable warming blanket group,28 cases)and group C(liquid heating combined with inflatable warming blanket group,30 cases).Each group received thermal insulation using corresponding insulation approaches.The three groups were compared in terms of nasal temperature at different perioperative time points,before anesthesia induction(T_(0)),one(T_(1)),two(T 2),three(T_(3)),four(T_(4))and five hours(T_(5))after operation initiation,at the end of operation(T_(6))and at the time of leaving postanesthesia care unit(PACU)(T_(7)),extubation time,PACU stay,thermal comfortableness score,and incidence rates of postoperative agitation,hypothermia and chills;the Quality of Recovery-40 Questionnaire(QoR-40)was used to evaluate postoperative recovery quality in the two groups 24 hours after operation.Results Perioperative body temperature presented a change tendency to initially decrease and then increase in the three groups,reduction in body temperature occurred at T 2 in group C and at T_(1) in other two groups;group C exhibited higher body temperature at T_(1) to T_(7) than group A or B(all P<0.05).Compared with group A or B,group C had shorter extubation time and PACU stay,lower incidence rates of postoperative chills,agitation and hypothermia,and higher postoperative thermal comfortableness(all P<0.05).Twenty-four hours after operation,group C yielded higher scores for body comfortableness,emotional state and pain and higher total score on QoR-40 in comparison with group A or B(all P<0.05).Conclusion Thermal insulation mode of liquid heating combined with inflatable warming blanket,compared with simple measure,can maintain cor
作者
李乐
张丽娜
武婷
王智
LI Le;ZHANG Li-na;WU Ting;WANG Zhi(Department of Anesthesiology,Stomatological Hospital of Xi′an Jiaotong University,Shaanxi Provincial Key Laboratory of Craniomaxillofacial Precision Medicine Research,Xi′an 710004,China)
出处
《广西医学》
CAS
2021年第5期524-528,共5页
Guangxi Medical Journal
基金
国家自然科学基金青年科学基金(81401138)
陕西省重点研发计划(2018SF-057)。
关键词
围术期保温
充气加温毯
液体加温
下颌骨肿瘤
肿瘤切除术
全身麻醉
低体温
术后恢复质量
Perioperative thermal insulation
Inflatable warming blanket
Liquid heating
Mandibular tumor
Tumor resection
General anesthesia
Hypothermia
Postoperative recovery quality
