充气加温毯对腹腔镜结直肠癌根治术后快速康复的影响  

Effects of Forced-air Warming Blanket on Enhanced Recovery after Surgery in Patients Undergoing Laparoscopic Radical Resection of Colorectal Cancer

作　　者：张俊霞 邓立琴[2] 王小梅 侯海涛 邱玉雪[2] ZHANG Junxia;DENG Liqin;WANG Xiaomei;HOU Haitao;QIU Yuxue(Ningxia Medical University,Yinchuan 750004,China;Department of Anesthesiology,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

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

出　　处：《宁夏医科大学学报》2022年第1期38-43,共6页Journal of Ningxia Medical University

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

摘　　要：目的探讨围术期采取充气加温毯联合常规保温措施对腹腔镜结直肠癌根治术老年患者围术期体温、术后并发症和快速康复的影响。方法选取全凭静脉麻醉下择期行腹腔镜结直肠癌根治术的老年患者70例,年龄65~75岁,身体质量指数(body mass index,BMI)18.5~30 kg·m^(-2),ASAⅡ或Ⅲ级。采用随机数表法分为充气保温组(forced-air warming group,FAW组)和常规保温组(conventional warming group,CW组),每组35例。CW组患者入室后给予常规体温保护策略,包括围术期监测核心体温、使用人工鼻、开启循环水温毯、及时被服覆盖、加温输注液体和灌洗液、调节合适的环境温度。FAW组患者在常规保温措施基础上在麻醉诱导前使用充气加温毯(38℃)预保温≥20 min;术中继续使用充气加温毯(冷风或38℃)维持正常体温。观察两组患者麻醉诱导后10 min、手术开始30 min、术中1 h、术中2 h、术毕、入麻醉后恢复室(post-anesthesia care unit,PACU)10 min、离开PACU时患者的核心温度;比较两组患者围术期低体温的发生率,术后寒战及术后其他并发症的发生情况,观察并记录两组患者术后首次通气时间、首次下床时间、首次排便时间、首次进食时间、住院时长、住院费用及术后患者满意度。结果FAW组术中各时间点核心体温高于CW组(P均<0.05)。FAW组围术期低体温(inadvertent perioperative hypothermia,IPH)、术后寒战及术后躁动的发生率均低于CW组(5.7%vs.22.9%,2.9%vs.28.6%及5.7%vs.31.4%),术后满意度高于CW组(P均<0.05)。FAW组术后首次通气时间、首次下床时间、首次排便时间、首次进食时间和住院时长均短于CW组(P均<0.01)。两组患者术后恶心呕吐、术后其他并发症及住院费用无明显差别。结论对腹腔镜结直肠癌根治术老年患者,围术期联合充气加温毯较单纯采取常规保温策略更有利于降低IPH的发生率,减少术后寒战和术后躁动,促进患者术�Objective To investigate the effects of forced-air warming blanket combined with conventional warming methods on perioperative hypothermia,postoperative complications and enhanced recovery in elderly patients undergoing laparoscopic radical resection of colorectal cancer.Methods In total,70 patients aged 65~75 years,BMI 18.5~30 kg·m^(-2),ASAⅡorⅢ,undergoing laparoscopic radical resection of colorectal cancer under total intravenous anesthesia,were enrolled.Patients were randomly divided into two groups(n=35 each)using a random number table:forced-air warming group(group FAW)and conventional warming group(group CW).Patients in group CW were given the conventional warming methods after entering the operating room,including monitoring the core temperature during the perioperative period,using the artificial nose,turning on the circulating water blanket,covering exposed skin in time,warming the infusion and irrigation liquids,adjusting the appropriate ambient temperature.Based on the conventional warming methods,patients in group FAW were received prewarming with forced-air warming blanket(38℃)for more than 20 minutes before induction of anesthesia and continued to use it(cold air or 38℃)during the operation to maintain normal body temperature.The core temperature in the two groups were recorded at the different time points,including 10 minutes after induction of anesthesia,30 minutes,1 hour,2 hours after operation,10 minutes after entering PACU,and before leaving from PACU.The incidence of perioperative hypothermia,postoperative shivering and other postoperative complications were calculated in two groups.The time to first passage of flatus,first activity of getting out of bed,first defecation,first intake of solid food,and the length of stay,the cost of stay and the satisfaction of patients after the operation were recorded.Results The temperatures at the different time points during the operation in group FAW were significantly higher than those in group CW(P all<0.05).The incidences of perioperative hypot

关 键 词：围术期低体温 充气加温毯 腹腔镜 结直肠癌根治术 术后加速康复 

分 类 号：R614[医药卫生—麻醉学] R735.3[医药卫生—外科学]