充气式保温毯联合输液加温对全麻食管癌手术苏醒和免疫功能的影响  

Effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune

作　　者：章敏[1] 谢言虎[1] 周玲[1] 李传耀[1] 柴小青[1] 

机构地区：[1]安徽医科大学附属安徽省立医院麻醉科,合肥市230001

出　　处：《临床麻醉学杂志》2016年第4期351-353,共3页Journal of Clinical Anesthesiology

摘　　要：目的探讨充气式保温毯联合输液加温技术对食管癌手术苏醒和免疫功能的影响。方法择期行食管癌根治术患者50例,随机分为温毯＋输液输血加温组（W组）和对照组（C组）,每组25例。记录麻醉诱导前（T1）、手术开始2h（T2）、手术结束时（T3）、术后2h（T4）的鼻咽温,及麻醉苏醒时间、术后寒战、术后感染及住院时间;采用流式细胞仪检测T1、T3、术后2d（T5）及5d（T6）外周血T淋巴细胞亚群。结果 C组在T2~T4时的鼻咽温较T1时明显降低（P〈0.05）;W组在T2~T4时的鼻咽温明显高于C组（P〈0.05）;C组患者苏醒时间明显延长、术后寒战发生率明显高于W组（P〈0.05）;与T1时比较,两组T3时CD4＋淋巴细胞百分率及CD4＋/CD8＋均明显下降,CD8＋淋巴细胞百分率明显升高（P〈0.05）;在T3时,W组CD4＋淋巴细胞百分率及CD4＋/CD8＋明显高于C组,CD8＋淋巴细胞百分率明显低于C组（P〈0.05）。结论在食管癌根治手术中,采用充气式保温毯联合输液加温技术具有保护患者体温、缩短患者苏醒时间、减少术后寒战的发生,同时有利于保护患者的免疫功能。Objective To investigate the clinical effect of forced-air warming system combined with infusion heating technology on recovery quality and cellular immune.Methods Fifty patients scheduled for esophagus cancer resection randomized into two groups（n=25each）：the temperature protection group（group W）and the control group（group C）.The intraoperative nasopharyngeal temperature was recorded before induction（T1）,2hours after operation（T2）,the end of operation（T3）,postoperative 2hours（T4）.The anesthesia wakening time,the occurrence of postoperative shivering and infection,hospitalization time were also recorded.Venous blood samples were taken at T1,T3,two days（T5）and five days after the operation（T6）for analysis of T-lymphocyte subsets by flow cytometry.Results Compared with T1,the nasopharyngeal temperature was significantly decreased at T2,T3 and T4in group C,and the nasopharyngeal temperature in group W was significantly higher than those in group C at T2,T3 and T4（P〈0.05）.The anesthesia wakening time and the occurrence of postoperative shivering in group C was significantly more than those in group C（P〈0.05）.Compared with T1,the percentage of CD4＋cells and CD4＋/CD8＋ratio were significantly decreased and the percentage of CD8＋cells increased in both groups at T3（P〈0.05）.Compared with group C at T3,the percentage of CD4＋cells and CD4＋/CD8＋ratio were significantly increased and the percentage of CD8＋cells decreased in group W（P〈0.05）.Conclusion The clinical use of forced-air warming system combined with infusion heating technology can protect the patient＇s body temperature,shorten the anesthesia wakening time,reduce the occurrence of postoperative shivering,which protects the patient＇s immune function and accelerates recovery after surgery.

关 键 词：体温 体温保护 食管肿瘤 T淋巴细胞 

分 类 号：R614.2[医药卫生—麻醉学] R735.1[医药卫生—外科学]