不同测温方式在肝移植患者术中体温监测中的应用对比研究  

A Comparative Study of Different Methods of Temperature Measurement in Intraoperative Temperature Monitoring of Liver Transplantation Patients

作　　者：莫小源 陶品月 卢舒雨 李涛[1] 曾菲[1] 刘娟娟 梁奕 刘秋艳 MO Xiao-yuan;TAO Ping-yue;LU Shu-yu;LI Tao;ZENG Fei;LIU Juan-juan;LIANG Yi;LIU Qiu-yan(Department of Anesthesia,the Second Affiliated Hospital of Guangxi Medical University,Guangxi,Nanning,530007)

机构地区：[1]广西医科大学第二附属医院麻醉科,530007

出　　处：《岭南急诊医学杂志》2023年第3期235-237,共3页Lingnan Journal of Emergency Medicine

基　　金：广西壮族自治区卫生健康委员会科研课题(Z-A20220641),(Z-A20220658)。

摘　　要：目的:探讨肝移植术中能准确灵敏反映核心体温变化的测温方式。方法:对30例进行肝移植手术的患者,于全身麻醉后同时测量肺动脉血液温度、鼻咽温度和直肠温度,记录腹腔打开时(T1)、无肝期前即阻断前5分钟(T2)、无肝期即阻断后30分钟(T3)、新肝初期即门脉开放后5分钟(T4)、新肝期即门脉开放后30分钟(T5)、腹腔关闭时(T6)六个时间节点三种测温方式温度值。结果:在T1、T2、T5及T6四个阶段三种测温方式无统计学意义,T3及T4血液温度与直肠温度、鼻咽温度与直肠温度两两比较存在统计学差异(P<0.05)。相关性分析,除了T1外,相关系数均r1>r2。结论:三种测温方法均能用于肝移植患者术中的体温监测,鼻咽温与血液温度有良好的相关性,在获取不到血液温度时,可通过监测鼻咽温度观察术中核心体温变化。使用直肠测温,在无肝期及新肝开放初期需结合血液温度或鼻咽温度监测来判断核心体温变化情况。Objective:To explore the accurate and sensitive method of core body temperature measurement during liver transplantation.Methods:Pulmonary artery blood temperature,nasopharyngeal temperature and rectal temperature were measured in 30 patients undergoing liver transplantation under general anesthesia,the temperature values were recorded at 6 time points:when the abdominal cavity was opened(T1),5 minutes before occlusion(T2),30 minutes after occlusion(T3),5 minutes after portal vein was opened(T4),30 minutes after portal vein was opened(T5),and when the abdominal cavity was closed(T6).Results:There were no significant differences in T1,T2,T5 and T6,but there were significant differences in T3 and T4 blood temperature and rectal temperature,nasopharyngeal temperature and rectal temperature(P<0.05).The correlation coefficient was r1r2 except T1.Conclusion:All the three methods can be used to monitor the temperature of the patients during the operation of liver transplantation,and the nasopharyngeal temperature has a good correlation with the blood temperature,the changes of core body temperature during operation can be observed by monitoring nasopharyngeal temperature.The core body temperature was measured by rectal thermometer,blood temperature or nasopharyngeal temperature monitoring in anhepatic phase and early stage of new liver opening.

关 键 词：肝移植 体温管理 体温监测 血液温度 鼻咽温度 直肠温度 

分 类 号：R614[医药卫生—麻醉学]