全麻下体温保护对老年胃肠手术患者凝血功能及血清乳酸含量的影响  

Effect of Body Temperature Protection under General Anesthesia on Blood Coagulation Function and Serum Lactic Acid in Elderly Patients Undergoing Gastrointestinal Surgery

作　　者：顾敏君 孙浩[1] 许玉 王鑫怡 濮茜虹 李艳[1] GU Minjun;SUN Hao;XU Yu;WANG Xinyi;PU Qianhong;LI Yan(Xiangcheng People’s Hospital of Suzhou,Suzhou 215100,China;不详)

机构地区：[1]苏州市相城人民医院,江苏苏州215100

出　　处：《中外医学研究》2021年第35期177-181,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨全身麻醉下体温保护对老年胃肠手术患者凝血功能及血清乳酸含量的影响。方法:采用前瞻性队列研究设计,选择2020年9月-2021年8月于苏州市相城区人民医院行胃肠手术的老年患者60例,采用随机数字表法分为试验组(术中体温保护,n=30)和对照组(术中常规保护,n=30),两组均进行全麻。监测患者各个时间点一般生命体征(鼻咽温、心率、血压),比较术前、术后两组凝血功能[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)]及血清乳酸含量。结果:两组鼻咽温及血压在各个时间点比较差异无统计学意义(P>0.05)。试验组T_(2)(麻醉后30 min)、T_(3)(麻醉后60 min)及T_(4)(术毕)心率明显低于对照组(P<0.05)。两组凝血功能四项比较差异无统计学意义(P>0.05)。试验组术后血清乳酸含量明显低于对照组,差异有统计学意义(P<0.05)。结论:全麻下体温保护对老年胃肠手术患者基本生命体征具有良好维持作用,对机体凝血功能无明显影响,并可有效降低血清乳酸含量,降低术后酸碱平衡紊乱发生可能。Objective:To investigate the effect of body temperature protection under general anesthesia on blood coagulation function and serum lactic acid in elderly patients with gastrointestinal surgery.Method:A prospective cohort study was applied,60 elderly patients who underwent gastrointestinal surgery from September 2020 to August 2021 in Xiangcheng People’s Hospital of Suzhou were selected,and they were divided into experimental group(intraoperative body temperature protection,n=30)and control group(intraoperative general care,n=30)by random number table method.The patients’general vital signs(nasopharyngeal temperature,heart rate,blood pressure)at different time points were monitored.The coagulation function[thrombin time(TT),prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB)]and serum lactic acid levels were compared between the two groups before and after surgery.Result:There were no statistically significant differences in nasopharyngeal temperature and blood pressure between the two groups at different time points(P>0.05).The heart rate in the experimental group was significantly lower than that in the control group at T_(2)(30 min after anesthesia),T_(3)(60 min after anesthesia),and T_(4)(after surgery)(P<0.05).There were no statistically significant differences in the coagulation function between the two groups(P>0.05).The level of postoperative serum lactic acid in the experimental group was significantly lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Body temperature protection under general anesthesia has a good maintenance effect on the basic vital signs of elderly patients undergoing gastrointestinal surgery.Meanwhile,it has no obvious effect on the coagulation function,and can effectively reduce the serum lactic acid content and reduce the possibility of postoperative acid-base balance disorder.

关 键 词：体温保护 老年患者 凝血功能 乳酸 

分 类 号：R614.2[医药卫生—麻醉学]