术前输注氨基酸对腰硬联合麻醉下膝关节镜检查患者围术期体温的影响  

Effects of preoperative amino acid infusion on perioperative body temperature of patients undergoing knee arthroscopy under combined spinal and epidural analgesia

作　　者：郑铭陟 刘慧敏 罗柳 易虎 毛鑫城 Zheng Ming-zhi;Liu Hui-min;Luo Liu;Yi Hu;Mao Xin-cheng(Department of Anesthesiology,Zhuzhou Central Hospital,Zhuzhou 412000,China)

机构地区：[1]株洲市中心医院麻醉科,株洲412000

出　　处：《湖南师范大学学报（医学版）》2021年第3期164-167,共4页Journal of Hunan Normal University(Medical Sciences)

摘　　要：目的:探讨术前输注氨基酸对膝关节镜检查患者围术期体温的影响。方法:选取80例株洲市中心医院择期行膝关节镜检查的患者为研究对象,按照随机数字表法将患者分为试验组和对照组,每组各40例。对照组患者进行腰硬联合麻醉下常规膝关节镜检查,试验组患者在麻醉前1h输注氨基酸(剂量为3.5mL/kg),再行腰硬联合麻醉下膝关节镜检查。比较两组患者麻醉前、麻醉后10 min、麻醉后30 min、麻醉后60min、麻醉后90 min和结束时的生命体征(HR、BP、SpO_(2))及鼓膜温度、术后的寒颤程度、术后温度舒适度等的差异。结果:两组患者不同时间点HR、BP、SpO2等生命体征指标比较差异无统计学意义;试验组患者各时点鼓膜温度正常,与麻醉前鼓膜温度比较差异无统计学意义,围术期无低体温发生;对照组各时间点鼓膜温度随时间呈现先下降后回升的变化,最低值为35.6℃,出现在麻醉后30min,比麻醉前下降1.1℃,明显低于试验组。术后2h内,试验组无一例患者发生寒颤,对照组17例患者发生寒颤,寒颤发生率为42.5%。试验组寒颤发生率明显低于对照组;试验组温度舒适度评分优于对照组,组间比较差异有统计学意义。结论:术前静脉输注氨基酸能有效减少膝关节镜检患者术中低体温发生率,减少术后寒颤,提高术后舒适度。Objective To explore the effect of preoperative infusion of amino acids on perioperative body temperature of patients undergoing knee arthroscopy.Methods 80 patients who underwent selective knee arthroscopy in Zhuzhou Central Hospital were selected as the research objects,and the patients were divided into experimental group and control group according to the random number table method,with 40 cases in each group.Patients in the control group underwent routine knee arthroscopy under combined spinal and epidural analgesia,while patients in the experiment group underwent knee arthroscopy under combined spinal and epidural analgesia after the infusion of amino acids(dose for 3.5 mL/kg)1 h before anesthesia.The vital signs(HR,BP,SpO_(2)),tympanic temperature,postoperative chill degree and postoperative temperature comfortability were compared between the two groups before,10 min,30 min,60 min,90 min and the end of anesthesia.Results There was no significant difference in HR,BP,SpO2 and other vital signs between the two groups at different time points.The tympanic temperature of the patients in the experiment group was normal at all time points,and there was no significant difference compared with the tympanic temperature before anesthesia.No hypothermia occurred during perioperative period.The tympanic temperature in the control group decreased first and then increased with time at each time point,with the lowest value of 35.6℃,which appeared 30min after anesthesia and decreased 1.1℃compared with that before anesthesia.Meanwhile,it was significantly lower than that in the experiment group.Within 2 h after operation,no patient in the experiment group developed chills,while 17 patients in the control group developed chills,with an incidence rate of 42.5%.The incidence of chills in the experimental group was significantly lower than that in the control group.The temperature comfort score in the experimental group was better than that in the control group,and the difference between the groups was statistically signif

关 键 词：膝关节 氨基酸 腰硬联合麻醉 体温 寒颤 

分 类 号：R614[医药卫生—麻醉学]