加温二氧化碳在预防腹腔镜手术患者低体温中的应用  

Application of warming carbon dioxide in prevention of hypothermia in patients undergoing laparoscopic surgery

作　　者：李欣 LI Xin(Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060)

机构地区：[1]天津医科大学肿瘤医院国家肿瘤临床医学研究中心天津市恶性肿瘤临床医学研究中心天津市"肿瘤防治"重点实验室

出　　处：《天津护理》2019年第3期265-268,共4页Tianjin Journal of Nursing

摘　　要：目的:探讨加温二氧化碳(CO2)在预防腹腔镜手术患者低体温中的应用效果。方法选取84例行腹腔镜手术患者,随机分为观察组和对照组,各42例。对照组予以常规处理,观察组予以加温CO2气腹机。比较两组手术情况(手术时长、术中出血量)、术中体温变化情况、术后寒战发生率、术后疼痛程度评分(VAS)、术前及术后两组氧分压(PO2)、二氧化碳分压(PCO2)变化情况。结果两组手术时长、术中出血量对比,差异无统计学意义(P>0.05);两组入室时至手术结束时体温呈下降趋势,且手术开始后30min、60min、90min及手术结束时观察组体温高于对照组,差异有统计学意义(P<0.05);观察组寒战发生率低于对照组,差异有统计学意义(P<0.05);两组术后1h至48hVAS评分呈降低趋势,且观察组低于对照组,差异有统计学意义(P<0.05);术前、术后两组PO2、PCO2,差异无统计学意义(P>0.05)。结论腹腔镜手术中加温CO2气腹机有助于维持围手术期体温,降低寒战发生率,缓解术后疼痛。Objective: To study on the application value of warming carbon dioxide(CO2)in prevention of hypothermia in patients undergoing laparoscopic surgery.Methods: A total of 84 patients undergone the laparoscopic surgery were selected and divided into groups according to the random number table, 42 cases in each. The control group was treated with routine treatment, and the observation group was treated with the warming CO2 pneumoperitoneum machine. The operation conditions(the length of operation and the amount of intraoperative bleeding), the changes of body temperature during surgery, postoperative chill incidence, postoperative pain score (VAS), and the changes of preoperative and postoperative blood gas indexes [oxygen partial pressure(PO2), carbon dioxide partial pressure (PCO2), plasma bicarbonate (HCO3), pH value] in two groups were statistically compared. Results: There were insignificant differences in the length of operation and the amount of intraoperative bleeding(P>0.05). The temperature of the two groups was decreased at the beginning and the end of the operation, and the temperature of the observation group was higher than the control group at the time of 30min, 60min and 90min after the operation and at the end of the operation, and the difference was statistically significant(P<0.05). The incidence of chills in the observation group was 4.76%, lower than that of the control group (30.92%)(P<0.05). The VAS score of two groups in postoperative1h to 48h showed a decreasing trend, and the observation group was lower than the control group, and the difference was statistically significant(P<0.05). There were insignificant differences in PO2, PCO2, HCO3 and pH value between the observation group and the control group before and after the operation(P>0.05). Conclusion: The warming CO2 pneumoperitoneum machine in the laparoscopic surgery is helpful to maintain the perioperative temperature, reduce the incidence of chills, and relieve the postoperative pain.

关 键 词：腹腔镜手术 加温二氧化碳气腹机 体温 寒战 

分 类 号：R473.6[医药卫生—护理学]