肝移植新肝期体温维护的研究  

Research on body-temperature in hepato-reperfusion phase in liver transplantation

作　　者：许多朵[1] 宋烽[1] 董薪[1] 

机构地区：[1]中国人民解放军总医院麻醉手术中心,北京100853

出　　处：《中国现代普通外科进展》2009年第5期420-422,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探讨维护新肝期体温的有效措施。方法:将73例使用充气式保温毯、血液加温仪、40℃温水间断冲洗、有完整体温记录的肝移植患者作为对照组;将肝移植手术中增加使用变温水毯的47例患者做为实验组。观察2组患者进入手术室、无肝期、新肝期的体温变化及最低体温出现时间并进行比较。结果:实验组与对照组除进入手术室、切皮期体温差异无统计学意义外(P>0.05),其余术中不同时间体温差异均有统计学意义(P<0.001)。对照组最低体温(34.77±0.93)℃,距门静脉开放后时间为(22.20±33.25)min;实验组最低体温(35.96±0.74)℃,距门静脉开放前时间为(33.40±92.84)min。结论:在新肝期提前升高变温水毯温度比仅使用充气式保温毯、血液加温仪、40℃温水间断冲洗等更有效,术中能有效防止低体温的出现。Objective： To research the effective measures of body-temperature preservation in hePato-reperfusion phase in liver transplantation, by observing the time of the temperature in anhepatic phase and hepato-reperfusion phase, and the time of lowest body-temperature in the surgery. Methods： The control group were 73 patients from June 2002 to October 2004, in which the inflatable insula- tion blanket, blood heating equipment and 40 ~C intermitent warm water washing were implemented, and the records of temperature were complete; The experiment group were 47 patients from March 2006 to AugUst 2007, in which thermostatical blanket was enhanced in liver transplantation operation. The obser- vations and comparisons were carried on two groups on body-temperature variation at the time of enter- ing operating-room, in anhepatic phase and hepato-reperfusion phase, also carried on the time of the lowest body-temperature, Results： There was significant difference on body-temperatures at different time in operation between two groups （P〈0.001）, except when entering operating-room and in skin-in- cision phase （P〉0.05）. The lowest temperature was （34.77 ± 0.93）℃ for the control group, and the time was （22.20± 33.25） min after the opening of portal vein; by contrast, the lowest temperature of （35.96 ± 0.74）℃ for the experiment group, and the time was （3314 ±92.84） min before the opening of portal vein. Conclusions： The warmer thermostatical blanket in advance in hepato-reperfusion phase is the more effective measures for body-temperature preservation than the inflatable insulation blanket, blood heating equipment, 40 ℃ intermittent warm water washing, and it can effectively prevent the emergence of low body-temperature during the operation.

关 键 词：肝移植 新肝期 体温 

分 类 号：R617[医药卫生—外科学]