加强防水处理对婴幼儿肝移植术中充气式热风毯保温效果的影响  

Effect of intensive waterproof method on intraoperative temperature preservation of pediatric patients during liver transplantation using forced-air warming blanket

作　　者：王菲[1] 张丽娜[1] 张梁[2] 田鸣[2] 

机构地区：[1]首都医科大学附属北京友谊医院手术室,100050 [2]首都医科大学附属北京友谊医院麻醉科,100050

出　　处：《中华现代护理杂志》2017年第6期837-839,共3页Chinese Journal of Modern Nursing

摘　　要：目的 探讨加强防水处理措施对婴幼儿肝移植术中充气式热风毯保温效果的影响.方法 选取2013年7月-2015年3月接受肝移植手术的患儿84例,采用随机数字表法分为对照组和试验组各42例.对照组术中应用Bair Hugger充气式热风毯进行常规保温护理,试验组为了避免加温毯和患儿两侧敷料被浸湿,在常规使用充气热风毯的基础上,采用加长加宽的防水膜对患儿进行加强防水处理.比较两组患儿在麻醉诱导后、手术开腹1 h、切肝期末、无肝期30 min、再灌注后、新肝期1 h、新肝期2 h和手术结束时的体温及患儿术中低体温发生率.结果 试验组和对照组患儿麻醉诱导后的体温分别为（36.18±0.25）、（36.15±0.24）℃,差异无统计学意义（P〉0.05）;其余时刻试验组患儿体温均高于对照组,差异有统计学意义（P〈0.05）;试验组患儿术中低体温的发生率为38.1%,低于对照组的78.5%,差异有统计学意义（P〈0.01）.结论 加强防水处理有利于提高婴幼儿肝移植术中充气式热风毯的保温效果.Objective To evaluate the effect of intensive waterproof method on intraoperative temperature preservation of pediatric patients during liver transplantation using forced-air warming blanket.Methods A total of 84 pediatric patients, who underwent liver transplantation from July 2013 to March 2015, were divided randomly into control group and experimental group, with 42 cases each. Patients in the control group received routine warming therapy using a Bair Hugger forced-air warming blanket, while patients in the experimental group, on the basis of conventional forced-air warming system, received modified warming therapy using an extended waterproof membrane to prevent the blanket and the baby from becoming wet. Body temperature at different time points between patients in the two groups was compared, including immediately after anesthesia induction, 1 h after incision, at the end of the preanhepatic stage, 30 min of anhepathic stage, immediately after reperfusion, 1 h of neohepatic stage, 2 h neohepatic stage, and at the end of the operation. Occurrence of hypothermia was also compared between the two groups.Results Temperature did not differ significantly after anesthesia induction in the experimental group （36.18±0.25） and the control group （36.15±0.24） （P〉0.05）, whereas the temperatures at other time points were significantly higher in the experimental group than in the control group （P〈0.05）. Incidence of hypothermia was significantly lower in the experimental group （38.1%）, than that in the control group （78.5%） （P〈0.01）.Conclusions The intensive waterproof method results in better maintenance of intraoperative normothermia during pediatric liver transplantation using forced-air warming blanket.

关 键 词：肝移植 体温 婴幼儿 充气式热风毯 防水保护 

分 类 号：R473.72[医药卫生—护理学]