不同保温方案对老年结直肠癌患者术中体温及麻醉恢复的影响  

作　　者：王静玉[1] 方平[1] 符聪[1] 

机构地区：[1]浙江省宁波市医疗中心李惠利医院,315000

出　　处：《浙江临床医学》2021年第6期905-907,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2021KY310);宁波市医学科技计划项目(2017A56)。

摘　　要：目的探讨使用充气保温毯的不同保温方案对老年结直肠患者术中体温及麻醉恢复的影响,方法120例行结直肠癌根除术的老年患者,根据术中不同的保温方案分为M组(38℃)、H组(43℃)、Z1组(43℃)h后调节为38℃和Z2组(43℃,2 h后调节为38℃),每组各30例。分别在手术基础麻醉生效后(T1)、手术开始后30 min(T2)、手术开始后60 min(T3)、手术开始后120 min(T4)与手术结束时(T5)检测患者的核心体温、平均动脉血压和心率等指标,记录患者术后苏醒时间及寒战、躁动、发热等发生情况。结果从进入手术室至手术结束,四组患者的核心体温均随时间延长呈逐步下降趋势(P<0.05)。在T3、T4两个时间点,Z1组、Z2组和H组的核心体温高于M组(P<0.01);Z1组患者T5的核心体温高于H组(P<0.05)。Z1组和Z2组患者的术后苏醒时间明显短于M组和H组(P<0.01);Z1组患者躁动的发生率低于M组、Z2组和H组(P<0.05);H组和Z2组患者发热的发生率高于Z1组和M组(P<0.05)。结论将充气保温毯设定为43 t、1h后调节为38℃的综合保温策略,有利于维持老年结直肠癌手术患者围术期体温保护,对术后麻醉恢复具有积极意义。Objective To investigate the effects of different thermal insulation programs using inflatable thermal insulation blankets on the body temperature and recovery of anesthesia in elderly patients with colorectal surgery.Methods 120 elderly patients undergoing radical resection of colorectal cancer were divided into M group(38℃),H group(43℃),Z1 group(43℃adjusted to 38℃ after 1 h)and Z2 group(43℃,adjusted to 38℃after 2 h),according to different heat preservation plans during the operation,30 cases in each group.After the basic anesthesia of the operation takes effect(T1),30 minutes after the start of the operation(T2),60 minutes after the start of the operation(T3),120 minutes after the start of the operation(T4),and at the end of the operation(T5),the patient's core body temperature and mean arterial blood pressure and heart rate and other indicators,record the postoperative wake-up time and the occurrence of chills,restlessness,fever and so on.Results From entering the operating room to the end of the operation,the core body temperature of the four groups of patients showed a gradual decrease over time(P<0.05).At the two time points of T3 and T4,the core body temperature of Z1,Z2 and H group was higher than that of M group(P<0.01);the core body temperature ofT5 of Z1 group was higher than that of H group(P<0.05).The postoperative recovery time of patients in group Z1 and Z2 was significantly shorter than that of group M and H(P<0.01);the incidence of restlessness in group Z1 was lower than that of group M,Z2 and H(P<0.05);group H The incidence of fever in group Z2 and Z1 was higher than that in group Z1 and M(P<0.05).Conclusion The comprehensive insulation strategy of setting the inflatable insulation blanket to 43 and adjusting to 38℃after 1 h is beneficial to maintain the perioperative temperature protection of elderly patients with colorectal cancer surgery and is of positive significance for postoperative anesthesia recovery.

关 键 词：结直肠癌根治术 老年患者 保温措施 麻醉恢复 

分 类 号：R47[医药卫生—护理学]