体重指数对舌颌颈联合根治术患者体温的影响及不同保温方式效果的比较  

Comparison of body mass index on body temperature in patients undergoing combined radical neck dissection and effectiveness of different heat preservation methods

作　　者：渠兴乾 范之丹 QU Xing-qian;FAN Zhi-dan(Department of Anesthesiology,Shanghai Ninth People s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院麻醉科

出　　处：《中国口腔颌面外科杂志》2019年第5期453-456,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:评价舌颌颈联合根治术中体重指数与体温的关系及不同保温措施的效果。方法:本研究分两部分进行观察,第一部分选取我院行舌颌颈联合根治术患者60例,根据患者体重指数(BMI)分为3组(每组20例),即正常体重组(N组),BMI 18.5~22.9;过重组(O组),BMI 23~24.9,轻度肥胖组(L组),BMI 25.0~29.9。患者麻醉诱导后置入鼻咽温探头,记录麻醉诱导后即刻(T0)、气管插管后10 min(T1)、30 min(T2)、60 min(T3)、90 min(T4)、120 min(T5)的体温。第二部分选取BMI在18.5~22.9的择期手术患者40例,采用随机数字表法将其分为2组(每组20例),即温液仪组(NA组)、温液仪+恒温毯组(NB)。采用SPSS 20.0软件包对数据进行统计学分析。结果:不同BMI组间比较,N组和O组仅T4、T5时点体温有显著差异(P<0.05);N组和L组,T2~T5时体温有显著差异(P<0.05);O组和L组,各时点体温无显著差异(P>0.05)。不同BMI组内比较,N组T1与T3、T4、T5体温有显著差异(P<0.05);T2与T4、T5有显著差异(P<0.05);T3与T4有显著差异。O组T1与T4、T5有显著差异。L组各时点比较无统计学差异。不同保温措施分析显示,同时点体温比较,NB组在T3、T4、T5时体温显著高于NA组(P<0.05),T1和T2时2组无显著差异(P>0.05)。NA组内T1与T4比较有显著差异(P<0.05),T2与T5时体温显著降低(P<0.05),T3-T5时体温变化差异无统计学意义。NB组内各时点体温无显著差异。结论:舌颌颈联合根治术中,高BMI值的患者比正常BMI值的患者更易保持体温稳定。温液仪有确切的保温效果,但温液仪联合恒温毯的保温效果更好。PURPOSE:To evaluate the relationship between body mass index(BMI)and body temperature in patients undergoing combined radical neck dissection and evaluate the effect of different thermal preservation measures.METHODS:Sixty patients who underwent combined radical neck dissection and surgery in our hospital were enrolled in this study according to stratified sampling method.The patients were divided into 3 groups(n=20),i.e.normal weight(group N,BMI 18.5-22.9 kg/m^2);over obesity(group O,BMI 23-24.9 kg/m^2),and mild obesity(group L,BMI 25.0-29.9 kg/m^2).Nasopharyngeal temperature of all patients was monitored immediately,10 min(T1),30 min(T2),60 min(T3),90 min(T4)and 120 min(T5)after tracheal intubation.Another 40 patients with BMI of 18.5-22.9 kg/m^2 were randomly divide into warm liquid instrument group(group NA,n=20)and warm liquid instrument combined with constant temperature blanket group(group NB,n=20).Temperature data were collected in the same way.The data were analyzed with SPSS 20.0 software package.RESULTS:Compared with the same time point between the groups with different BMI values:the temperature of group N and group O showed significant difference only at T4 and T5(P<0.05).There was significant difference in body temperature between group N and group L at T2-T5(P<0.05).Difference in temperature was not statistically significant at each time point between group O and group L(P>0.05).Intra-group comparison:temperature at T1 and T3,T4 and T5 was significantly different in group N(P<0.05);temperature at T2 was significantly different between T4 and T5(P<0.05);the difference between T3 and T4 was statistically significant.In group O:there was significant difference at T1,T4 and T5.In group L:no significant difference was found at each time point.At the same time point,temperature in group NA and group NB was significantly higher at T3,T4 and T5(P<0.05).In the group NA,there was significant difference between T1 and T4(P<0.05);hypothermia at T2 and T5(P<0.05);there was no significant difference in temperatu

关 键 词：体重指数 低体温 舌颌颈联合根治术 

分 类 号：R782.05[医药卫生—口腔医学]