麻醉前加温输液对蛛网膜下腔麻醉患者中心体温及寒战的影响  

Influence of Heated Infusion on the Core Temperature and Shivering of Patients Receiving Spinal Anesthesia

作　　者：时君[1] 姜晓红[1] 袁力勇[1] 

机构地区：[1]宁波市第六医院麻醉科,315040

出　　处：《医学研究杂志》2015年第12期85-88,共4页Journal of Medical Research

基　　金：宁波市自然科学基金资助项目(2009A610140);宁波市优秀中青年卫生技术人才基金资助项目(2007201)

摘　　要：目的评估麻醉前加温输液对蛛网膜下腔麻醉患者中心体温及寒战的影响。方法ASAⅠ级、择期在蛛网膜下腔麻醉下行下肢骨科手术患者120例,随机分为麻醉前加温输液组（A组）及麻醉前未加温输液组（B组）,每组60例。A组患者以输液加温器加温液体,保证整个输液过程液体温度在37.5±0.5℃范围内;B组患者未在蛛网膜下腔麻醉前加温输液,待麻醉完成后开始以37.5±0.5℃温度加温输液。比较两组患者入手术室、麻醉开始前、蛛网膜下腔麻醉后5、10、20、30、45、60、90、120min、术毕的中心体温（肛温）,寒战程度、发生率及发生时间。结果（1）A组患者各时间点中心体温相似（F=1.157,P=0.108）,B组患者各时间点中心体温差异有统计学意义（F=2.355,P=0.032）,其中以蛛网膜下腔麻醉前、蛛网膜下腔麻醉后5、10、20、30min较低;麻醉前、蛛网膜下腔麻醉后5、10、20、30min,A组患者中心体温明显高于B组（t=2.578、2.822、2.173、2.137、2.157;P=0.021、0.009、0.032、0.039、0.036）;蛛网膜下腔麻醉后45、60、90、120min及术毕两组患者的中心体温相似;（2）A组有9例（15%）患者出现寒战, B组有29例（48%）患者出现寒战,寒战总发生率A组低于B组（χ^2=15.404,P=0.001）,其中0～5min期间及5～10min期间A组低于B组（χ^2=6.400,P=0.011;χ^2=5.217,P=0.022）,而10～20min期间两组相似（χ^2=3.077,P=0.079）。寒战发生程度1、2、3、4级者A组分别为5、3、1及0例,B组分别为10、8、9及2例。结论与麻醉后加温输液相比,蛛网膜下腔麻醉前加温输液能有效保持患者中心体温,并明显降低蛛网膜下腔麻醉后寒战的发生率。Objective To evaluate the influence of heated infusion before anesthesia on the core temperature and shivering of patients receiving spinal anesthesia. Methods ASAⅠ,120 patients were randomly divided into group A and group B,60 cases in each group. Patients in groupA were infused heated liquid before spinal anesthesia, to ensure that the entire process of infusion liquid at a temperature of 37.5±0.5℃.Patients in group B were infused heating liquid after spinal anesthesia,and also to ensure that the entire process of infusion liquid at a temperature of 37.5±0.5℃.The core temperature,the degree and incidences of shivering of patients in two groups were compared. Results In group A,the core temperature at different time piont were similar. Compared with group A, the core temperature in group B at before anesthesia,5,10,20,30 minutes after spinal anesthesia were lower, respectively.The incidences of shivering were 15% in group A and 48% in group B.The incidences of shivering in groupA were lower than that in groupB. Conclusion Infused heated liquid before,rather than after spinal anesthesia can effectively maintain the core temperature,and significantly reduce the incidences of shivering.

关 键 词：加温输液 蛛网膜下腔麻醉 中心体温 寒战 

分 类 号：R4[医药卫生—临床医学]