冲洗液温度对开胸手术患者生命体征及麻醉恢复期的影响  

Effects of Flushing Fluid Temperature on Life Indexes and Anesthesia Recovery Period in Patients with Thoracotomy

作　　者：姜雪[1] 陈丽媛[1] 陈素兰[1] 丁宝艳[1] 李娟[1] 薛玉洁[1] 

机构地区：[1]第四军医大学唐都医院手术室,西安710038

出　　处：《解放军护理杂志》2011年第7期16-18,共3页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨开胸手术中采用不同温度的生理盐水冲洗胸腔对患者心率、血压、心律及麻醉恢复期的影响。方法选择全麻开胸手术患者220例,按照随机数字表法分为两组,每组110例,对照组用与室温相同（22~24℃）的生理盐水冲洗胸腔,实验组用加热至接近胸腔温度（38~40℃）的生理盐水冲洗胸腔,分别记录两组患者手术前、冲洗前、冲洗后体温的变化,冲洗前后心率和血压的变化,麻醉恢复期拔管时间、完全清醒时间、心室颤动及寒战的发生率。结果冲洗前,两组患者体温均有所下降,但组间比较差异无统计学意义;冲洗后,对照组患者体温下降明显,与实验组比较差异有统计学意义（P〈0.01）。对照组患者冲洗胸腔后,心率增快、血压降低,且与冲洗前比较,差异均有统计学意义（P〈0.05）。实验组患者术后完全清醒时间短于对照组,心室颤动及寒战发生率均低于对照组,差异有统计学意义（P〈0.05）。结论加温冲洗液对患者的生命体征影响不明显,可有效预防心律失常的发生,并有利于患者麻醉期恢复;但单纯加温冲洗亦不能完全阻止体温的下降,可考虑采取综合性的保温措施。Objective To investigate the effect of thoracic cavity washing with normal saline（NS） of different temperature on heart rate,blood pressure,arrhythmia and anesthesia convalescent of patients with thoracotomy.Methods A total of 220 patients with thoracotomy were equally randomized into experimental and control groups.The control group and the experimental group were given room temperature（22-24℃）NS and thoracic cavity temperature（38-40℃）NS to wash thoracic cavity respectively.The body temperature was recorded before operation,before and after washing.Results The body temperature declined in the control and experimental groups before NS washing without significatn difference between the two group（P0.05）.Compared with the experimental group,the body temperature were significantly decreased in the control group after NS washing（P0.01）.For the patients in the control group,the heart rate was significantly increased and the blood pressure was significantly decreased after NS washing（P0.05）.The complete convalescence of anesthesia was significantly less and the incidents of ventricular fibrillation and chill were lower in the experimental group than in the control group（P0.05）.Conclusion Warming flushing fluid has no significant effect on signs of life,but helps to prevent arrhythmia and promote recover stage of narcosis.However,simple warming flushing fails to completely prevent temperature decline,and comprehensive insulation measures are suggested to be considered.

关 键 词：冲洗液温度 胸腔冲洗 生命体征 心室颤动 麻醉恢复期 

分 类 号：R472.3[医药卫生—护理学]