充气式保温系统对老年全髋关节置换术患者体温、胃肠功能及炎性因子的影响  

Effects of the inflatable thermal insulation system with varied thermal insulation modes on body temperature,gastrointestinal function and inflammatory factors in elderly patients undergoing total hip arthroplasty

作　　者：乔婷婷 董佩龙[2] 李同[1] 李玉[3] 陆立岚[1] QIAO Tingting;DONG Peilong;LI Tong(Anesthesia Operating Room,Jianhu People’s Hospital,Jiangsu,Yancheng 224700,China;不详)

机构地区：[1]江苏省建湖县人民医院麻醉手术室,224700 [2]江苏省建湖县人民医院关节科,224700 [3]江苏省建湖县人民医院门诊部,224700

出　　处：《河北医药》2023年第19期2955-2958,共4页Hebei Medical Journal

基　　金：盐城市医学科技发展计划项目(编号:YK2021076);第五期“333工程”科研资助项目(编号:BRA2018250)。

摘　　要：目的探究并分析充气式保温系统对老年髋关节置换术患者体温胃肠功能、血浆中C-反应蛋白、白介素细胞-6(IL-6)、IL-17A表达的影响。方法选取2020年1月至2021年1月收治的75例老年髋关节置换手术患者,按照随机数字表法将其分为对照组37例和观察组38例。2组患者均采用充气式保温系统,对照组设置为37℃档,观察组设置为39℃档。收集2组患者一般资料,观察并记录2组患者围术期体温、手术前后胃肠道症状积分及炎性因子[包括γ-谷氨酰转肽酶(γ-GGT)、IL-6]。结果2组患者麻醉入室前温度比较无显著差异(P>0.05),麻醉诱导后从手术划皮开始2组患者对照组患者体温呈降低趋势,T3、T4时刻观察组患者体温较T0时刻显著升高(P<0.05),T2、T3、T4时刻对照组体温较T0时刻显著降低(P<0.05),T2、T3、T4时刻对照组体温显著低于观察组(P<0.05);2组患者术前胃肠道症状积分无明显差异(P>0.05),术后2组患者消化症状积分均较前显著升高(P<0.05),术后对照组患者消化道症状积分升高程度明显大于对照组(P<0.05),经重复方差分析,2组患者手术前后炎性因子(γ-GGT、IL-6)比较差异显著(F=11.24、P=0.001,F=7.54、P=0.007,F=9.58、P=0.002;F=12.31、P=0.000,F=8.35、P=0.003,F=10.65、P=0.001),2组患者术前炎性因子(γ-GGT、IL-6)比较差异无统计学意义(P>0.05),术后6 h 2组患者γ-GGT浓度较术前显著降低(P<0.05),而术后6 h 2组IL-6浓度均较术前显著升高(P<0.05),术后6 h观察组患者IL-6水平明显低于对照组(P<0.05),术后6 h观察组患者γ-GGT水平明显高于对照组(P<0.05)。结论充气式保温系统中39℃档相对于37℃档在老年髋关节置换的患者中具有更好的保温效果,患者术后胃肠道功能受损也较37℃档患者轻,且术后炎性因子的释放减少,值得临床推广。Objective To explore and analyze the effects of inflatable thermal insulation system on body temperature and the plasma levels of C-reactive protein(CRP),interleukin-6(IL-6)and IL-17A in elderly patients undergoing total hip arthroplasty.Methods A total of 75 elderly patients treated with total hip arthroplasty in our hospital from January 2020 to January 2021 were recruited.They were randomly divided into control group(n=37)and observation group(n=38).The inflatable thermal insultation system was adopted in both groups,with the thermal insultation temperature of 37℃and 39℃in the control group and observation group,respectively.The general data of the two groups were collected.Perioperative body temperature,gastrointestinal symptom scores before and after operation and inflammatory factors(includingγ-glutamyl transpeptidase[γ-GGT]and IL-6)were compared between groups.Results There was no significant difference in the temperature before anesthesia between the two groups(P>0.05).After the induction of anesthesia,the body temperature of patients in both groups showed a downward trend from the time of skin incision(P<0.05).The body temperature in the observation group at T3 and T4 was significantly higher than that at T0(P<0.05),which,in the control group at T2,T3,and T4 was significantly lower than that at T0(P<0.05).The body temperature in the control group at T2,T3,and T4 was significantly lower than that in the observation group(P<0.05).There was no significant difference in the score of gastrointestinal symptoms before surgery(P>0.05),which were significantly enhanced after surgery(P<0.05).The increase in the postoperative score of gastrointestinal symptoms in the observation group was significantly higher than that in the control group(P<0.05).After repeated analysis of variance,there were significant differences in inflammatory factors(γ-GGT,IL-6)between groups before and after surgery(F=11.24,P=0.001,F=7.54,P=0.007,F=9.58,P=0.002;F=12.31,P=0.000,F=8.35,P=0.003,F=10.65,P=0.001,respectively).The preopera

关 键 词：体温 不同模式保温系统 老年患者 髋关节置换手术 炎性因子 

分 类 号：R687.4[医药卫生—骨科学]