大肝癌切除术中及术后低体温对患者术后康复的影响  

Effects of intraoperative and postoperative hypothermia on recovery in patients with large hepatocellular carcinoma undergoing hepatectomy

作　　者：李湘[1] 莫新少[1] 陈似霞[1] 杨一兰[2] 

机构地区：[1]广西医科大学第一附属医院肝胆外科,南宁530021 [2]广西医科大学第一附属医院麻醉科,南宁530021

出　　处：《中国癌症防治杂志》2014年第1期74-77,共4页CHINESE JOURNAL OF ONCOLOGY PREVENTION AND TREATMENT

基　　金：教育部省部共建重点实验室课题(GK2013-13-A-01-04);广西卫生厅自筹科研课题(Z2013078)

摘　　要：目的探讨大肝癌切除术中及术后麻醉复苏期低体温对患者术后康复的影响，为临床体温护理提供科学依据。方法将160例术中及术后麻醉复苏期的大肝癌切除术患者，按低体温强度分为A1组（体温〈35℃，41例）、A2组（体温35～35．5℃，85例）、A，组（体温35．6～35．9℃，34例）；同时根据低体温持续时间分为B1组（时间〈1h，35例）、B2组（时间为1~2h，47例）、B3组（时间〉2h，78例）。比较各组麻醉清醒时间、术后第1天腹腔引流量、术前及术后第5天肝功能、切口愈合及术后住院时间。结果A1组较A2组、A3组麻醉清醒时间、切口愈合时间及术后住院时间均延迟（P〈0．05）；屯组较A1组、A2组术后第1天腹腔引流量减少、术后第5天谷丙转氨酶（ALT）和谷草转氨酶（AST）降低（P〈0．05）；B，组较B1组、B2组麻醉清醒时间延长、术后第5天ALT和AST恢复减慢；B3组较B1组术后第1天腹腔引流量增加（P〈0．05）。B1组、B2组、B3组的切口愈合时间及术后住院时间比较差异无统计学意义（P〉0．05）。结论体温〈35℃对患者的术后康复影响较大，应加强术中及术后麻醉复苏期患者的体温监测，及早发现低体温并采取积极有效的复温措施，减少低体温对患者术后的不良影响，促进患者康复。Objective To investigate the effects of intraoperative and postanesthesia hypothermia on recovery in patients with large hepatocellular carcinoma （HCC） undergoing hepatectomy. Methods A total of 160 hypothermic patients were divided into three groups according to the severity of hypothermia：T〈35℃（n=41 ,group Al）,35-35.5℃（n=85,A2） and 35.6-35.9℃（n=34,A3）.In a separate analysis, patients were divided into three groups according to the duration of hypothermia：： 〈1 h （n=35, B1）, 1-2 h（n=47, B2）, and〉2 h （n=78, B3）.Postanesthesia recovery time ,first postoperative peritoneal drainage volume, 5th postoperative ALT and AST levels ,wound healing time and duration of postoperative hospitalization were compared among the groups. Results Anesthestia recovery time was longer in A1 than in the other A groups, and longer in B3 than in the other B groups.First postoperative peritoneal drainage was higher and 5th postoperative ALT levels were lower in A1 and B3 than in the respective A and B groups（P〈0.05）.Group A3 showed the lowest 5th postoperative ALT level and longest wound healing and postoperative hospitalization（P〈0.05 ）. Conclusion Body temperature 〈35℃ significantly affects patient recovery.Greater attention should be paid to body temperature monitoring and effective rewarming in order to minimize postoperative complications due to hypothermia.

关 键 词：肝肿瘤 低体温 鼓膜温度 康复 护理 

分 类 号：R473.73[医药卫生—护理学]