充气加温毯对腹腔镜结直肠癌根治性切除术老年患者术后恢复质量和认知恢复的影响  

Effects of forced-air warming blanket on the quality of postoperative recovery and cognitive recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer

作　　者：陈岗[1] 张俊霞 邓立琴[1] 王小梅 侯海涛 邱玉雪[1] Chen Gang;Zhang Junxia;Deng Liqin;Wang Xiaomei;Hou Haitao;Qiu Yuxue(Department of Anesthesiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Clinical Medicine School,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院麻醉科,银川750004 [2]宁夏医科大学总医院临床医学院,银川750004

出　　处：《中华老年医学杂志》2021年第10期1299-1303,共5页Chinese Journal of Geriatrics

基　　金：2020年宁夏回族自治区重点研发计划项目(2020BEG03028)。

摘　　要：目的探讨充气加温毯联合常规保温策略对腹腔镜结直肠癌根治术老年患者术后恢复质量及认知恢复的影响。方法采用前瞻性、随机对照研究,选择全麻下行腹腔镜结直肠癌根治术的老年患者70例,年龄65~75岁,美国麻醉医师协会(ASA)分级Ⅱ或Ⅲ级。采用随机数字表法分为充气保温组和常规保温组,每组35例。比较两组患者围术期低体温(IPH)、术后寒战、躁动、麻醉苏醒时间及其他术后并发症的发生率;采用术后恢复质量评估量表(PQRS)评估术前、术后1、3及7 d整体恢复质量和认知功能恢复情况。结果与常规保温组比较,充气保温组IPH发生率(5.7%和22.8%,χ^(2)=4.200,P=0.042),术后寒战的发生率(2.8%和28.6%,χ^(2)=10.057,P=0.003);术后躁动的发生率均明显降低(5.7%和31.4%,χ^(2)=7.652,P=0.006);术后48 h患者满意度明显增加(P<0.01);常规保温组患者术后苏醒时间明显延长(P<0.01)。充气保温组术后1 d整体恢复质量优良比例明显增加(P<0.05)。术后3 d、7 d两组患者整体恢复质量及认知功能恢复无明显差异。结论对腹腔镜结直肠癌根治术老年患者围术期采取充气加温毯联合常规保温措施有利于降低围术期低体温的发生率,减少术后寒战,提高术后1 d整体恢复质量,但对术后认知恢复无影响。Objective To investigate the effects of forced-air warming blankets combined with conventional warming strategies on the quality of postoperative recovery and cognitive recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods This was a prospective,randomized,controlled trial.A total of 70 patients aged 65-75 years,who were classified as American Society of Anesthesiologists(ASA)grade-ⅡorⅢ,undergoing the laparoscopic radical resection of colorectal cancer under general anesthesia,were enrolled.Patients were randomly divided into two groups:the forced-air warming group(group FAW,n=35)and the conventional warming group(group CW,n=35).The inadvertent perioperative hypothermia(IPH),postoperative shivering,postoperative agitation,anesthesia recovery time and other postoperative complications were compared between the two groups.The post-operative quality of recovery scale(PQRS)was used to evaluate the quality of postoperative recovery and the recovery of cognitive function before and 1,3,and 7 days after operation.Results As compared with the group CW,the group FAW showed that the incidences of IPH,postoperative shivering and agitation were decreased(5.7%vs.22.8%,2.8%vs.28.6%,5.7%vs.31.4%,χ^(2)=4.200,10.057 and 7.652,P=0.042,0.003 and 0.006),and the satisfaction degree of patients was increased at 48 hours after operation(P<0.01).The postoperative wake-up time was prolonged in the group CW as compared with the group FAW(P<0.01).Compared with the group CW,the proportion of patients with excellent overall recovery quality was increased in the group FAW 1 day after surgery(P<0.05).There was no significant difference in general recovery quality and cognitive recovery between the two groups at 3 and 7 days after operation.Conclusions For elderly patients undergoing laparoscopic radical resection of colorectal cancer,the forced-air warming blanket combined with conventional warming strategies is more helpful to decrease the incidence of IPH,reduce postoperative shivering and i

关 键 词：低温 结直肠肿瘤 腹腔镜 功能恢复 认知 

分 类 号：R735.34[医药卫生—肿瘤]