下半身充气保温在胸腔镜肺癌根治术患者中的应用效果观察  

Observation on the application effect of lower body inflatableinsulation in patients undergoing thoracoscopic radical resection of lung cancer

作　　者：耿陈玲 丁胜光 李培培[1] 田婷[1] GENG Chen-ling;DING Sheng-guang;LI Pei-pei;TIAN Ting(Operating Room,The Second Affiliate Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学第二附属医院手术室,江苏南通226001

出　　处：《实用医院临床杂志》2023年第5期83-86,共4页Practical Journal of Clinical Medicine

基　　金：江苏省南通市科技计划项目(编号:JC2018099)。

摘　　要：目的 探讨下半身充气保温对胸腔镜肺癌根治术患者核心体温及细胞免疫功能的影响。方法 选择2020年3月至2022年10月在我院拟行胸腔镜肺癌根治术患者83例,采用随机数字表法分为观察组(42例)与对照组(41例)。在常规手术室保温干预的基础上,对照组给予充气式保温毯覆盖上半身,观察组给予充气式保温毯覆盖下半身。麻醉诱导前(T_(0)),麻醉诱导后30 min(T_(1))、60 min(T_(2))、90 min(T_(3))、120 min(T_(4))、术毕(T_(5)),比较两组核心体温(鼓膜温度);T_(0)、T_(5)时比较两组T淋巴细胞亚群;观察两组寒颤、恶心呕吐、低氧血症、躁动等并发症发生情况。结果 观察组T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时核心体温均高于对照组(P<0.05);T_(5)时CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05);寒颤及并发症总发生率低于对照组(P<0.05)。结论 下半身充气保温有助于维持胸腔镜肺癌根治术患者核心体温的相对稳定,缓解细胞免疫功能抑制症状,减少围术期寒颤等并发症的发生。Objective To investigate the effect of lower body insulation on core body temperature and cellular immune function of patients undergoing thoracoscopic radical resection of lung cancer.Eighty-three patients who planned to undergo thoracoscopic radical resection of lung cancer from March 2020 to October 2022 were selected.The patients were divided into an observation group(n=42)and a control group(n=41).The control group was given forced air warming blanket covering the upper body while the observation group was treated forced air warming blanket covering the lower body.The core body temperature(tympanic membrane temperature)before induction of anesthesia(T_(0)),after 30 minutes(T_(1)),60 minutes(T_(2)),90 minutes(T_(3)),120 minutes(T_(4))of induction of anesthesia and after surgery(T_(5))were compared between the two groups.T lymphocyte subsets at T_(0) and T_(5) were compared between the two groups.After operation,chills,nausea and vomiting,hypoxemia and agitation as well as complications were recorded.The core body temperature of the observation group at T_(2),T_(3),T_(4) and T_(5) was higher than that in the control group(P<0.05).The levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)at T_(5) were higher while CD8^(+)was lower in the observation group than those in the control group(P<0.05).The incidence of chills and complications in the observation group was lower than that in the control group(P<0.05).Lower body insulation helps to maintain the relative stability of core body temperature in the patients undergoing thoracoscopic radical resection of lung cancer,relieves the inhibition of cellular immune function,and prevents the perioperative chills and complications.

关 键 词：胸腔镜肺癌根治术 充气式保温毯 下半身保温 核心体温 细胞免疫功能 

分 类 号：R473.7[医药卫生—护理学]