摘要
目的探讨术中保温输液对在全身麻醉下行经尿道前列腺电切术(transurethral resection of prostate,TURP)的老年患者体温变化、寒战发生情况、术后麻醉复苏及凝血功能的影响。方法选择上海市浦东新区人民医院2021年8月—2022年2月择期在全身麻醉下行经尿道前列腺电切术的患者60例,采用随机数字表法分为观察组和对照组,每组30例。2组室温均控制在22~24℃,患者入室后均使用棉被覆盖上身,使用中单包裹双下肢。对照组在术中使用室温下的灌洗液、静脉输液,观察组在术中使用经加温输液仪恒温加热的灌洗液、静脉输液,设定液体输入温度为36℃。观察并比较2组的寒战发生率、围术期各时间点的体温变化、麻醉苏醒时间及凝血功能指标值。结果对照组在术中各时间点体温均有不同程度下降,观察组在术中体温较为恒定,且观察组在麻醉后10min、麻醉后30min、麻醉后60min以及手术结束后1h的体温明显高于对照组(P<0.05);对照组寒战发生率也明显高于观察组(P<0.05);对照组术后苏醒时间为(10.6±1.8)min,观察组术后苏醒时间为(7.9±1.5)min,对照组术后苏醒时间较观察组明显延长(P<0.05);各项凝血功能指标比较,对照组较观察组的纤维蛋白原水平(fibrinogen,FIB)和血小板(platelet,PLT)均明显降低(P<0.05)。结论术中通过加温输液仪保温输液可使老年前列腺增生患者保持体温相对稳定,减少术后寒战的发生,缩短患者术后苏醒时间以及减少凝血功能障碍的发生,有效减少了TURP术后各种并发症的发生。
Objective To investigate the effects of intraoperative thermal infusion on the changes of body temperature,shivering,postoperative anesthesia resuscitation and coagulation function in elderly patients undergoing transurethral resection of prostate(TURP)under general anesthesia.Methods A total of60patients who underwent TURP under general anesthesia in Pudong New District People’s Hospital from August2021to February2022were selected and divided intoobservation group and control group by random number table method,with30cases in each group.The room temperature in both groups was controlled at22-24℃.After entering the room,the upper body of the patients was covered with cotton quilts,and their lower limbs were wrapped with a middle sheet.The control group received lavage fluid and intravenous fluid at room temperature during the operation.The observation group used lavage fluid and intravenous fluid heated by a heating infusion apparatus during the operation,and the fluid input temperature was set at36℃.The incidence of shivering,the changes in body temperature at each time point during the perioperative period,the recovery time from anesthesia and coagulation function indexes were observed and compared between the two groups.Results The body temperature of the control group decreased in varying degrees at each time point during the operation.The body temperature of the observation group was relatively constant during the operation.The body temperature of the observation group was significantly higher than that of the control group at10min,30min,60min and1h after the operation(P<0.05).The incidence of shivering in the control group was also significantly higher than that in the observation group(P<0.05).The postoperative recovery time was(10.6±1.8)min in the control group and(7.9±1.5)min in the observation group.The postoperative recovery time of the control group was significantly longer than that of the observation group(P<0.05).The levels of fibrinogen(FIB)and platelets(PLT)in the control group were signi
作者
黄静芬
李香盛
段存豪
Huang Jingfen;Li Xiangsheng;Duan Cunhao(Operating Room,Pudong New District People’s Hospital of Shanghai City,Shanghai,201201,P.R.China)
出处
《老年医学与保健》
CAS
2022年第3期493-496,512,共5页
Geriatrics & Health Care
关键词
老年
经尿道前列腺电切术
全身麻醉
寒战
麻醉复苏
术中保温输液
elderly
transurethral resection of prostate
shivering
general anesthesia
anesthesia resuscitation
intraoperativethermal infusion
