多模式体温管理对腰椎后路融合术后患者早期恢复的影响  

作　　者：胡立 周红梅[1] 吴城[1] 章斌 

机构地区：[1]嘉兴学院附属第二医院,314000

出　　处：《浙江临床医学》2022年第4期588-590,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省嘉兴市科技计划项目(2018AD32022)。

摘　　要：目的探讨多模式体温管理策略对腰椎后路融合术患者术后早期恢复的影响。方法回顾性分析2018年7月至2020年6月在嘉兴学院附属第二医院择期于气管插管静吸复合全身麻醉下行腰椎后路融合术的患者678例,根据术中保温方法的不同分为多模式体温管理组(D组,215例)和常规保温组(C组,377例),采用卡钳值倾向性评分匹配后,292例患者资料匹配成功,每组各146例。比较倾向性评分匹配前后两组患者的基线指标和术后指标。结果倾向性评分匹配后,D组的围术期低体温、术后躁动、术后寒战、深静脉血栓(DVT)、术后入住重症监护室(ICU)例数均少于C组,术后拔管时间、麻醉恢复室(PACU)停留时间、凝血酶原时间(PT)及部分活化凝血酶原时间(APTT)均短于C组,血小板计数低于C组,差异均有统计学意义(P<0.05)。两组的肺部感染、切口感染、尿路感染例数比较,差异无统计学意义(P>0.05)。结论多模式体温管理策略有利于腰椎后路融合术患者早期恢复,但是并不能减少术后感染的发生。Objective To explore the effect of multimodal temperature management strategy on early postoperative recovery of patients undergoing posterior lumbar fusion.Methods A retrospective analysis was made of 678 patients who underwent posterior lumbar fusion under endotracheal intubation and inhalation combined with general anesthesia in the Second Affiliated Hospital of Jiaxing University from July 2018 to June 2020.According to the different methods of intraoperative heat preservation,they were divided into multimodal temperature management group(Group D,215 cases)and conventional heat preservation group(group C,377 cases),and the data of 292 patients were matched successfully after using the caliper value propensity score matching,with 146 cases in each group.The baseline and postoperative indexes of the two groups were compared before and after propensity score matching.Results After propensity score matching,the perioperative hypothermia,postoperative agitation,postoperative shivering,deep venous thrombosis(DVT)and postoperative admission to intensive care unit(ICU)in group D were less than those in group C.The postoperative extubation time,stay time in anesthesia recovery unit(PACU),prothrombin time(PT)and partially activated prothrombin time(APTT)in group D were shorter than those in group C,and the platelet count was lower than that in group C,and the difference was statistically significant(P<0.05).There was no significant difference in the number of pulmonary infection,incision infection and urinary tract infection between the two groups(P>0.05).Conclusion Multimodal temperature management strategy is beneficial to the early recovery of patients undergoing posterior lumbar fusion,but it can not reduce the incidence of postoperative infection.

关 键 词：体温管理 腰椎手术 术后恢复 术后感染 

分 类 号：R47[医药卫生—护理学]