围手术期保温干预对全身麻醉胸腔镜肺手术患者应激反应及并发症的影响  

Effects of perioperative period thermal insulation intervention on stress response and complications in patients undergoing thoracoscopic lung surgery under general anesthesia

作　　者：王艳 阎莉[1] 张建梅[1] 仲兆萍 WANG Yan;YAN Li;ZHANG Jianmei;ZHONG Zhaoping(Department of Surgery Anesthesiology,Huaian First People’s Hospital,Jiangsu Province,Huaian223300,China)

机构地区：[1]江苏省淮安市第一人民医院手术麻醉科,江苏淮安223300

出　　处：《中国医药导报》2023年第31期119-123,共5页China Medical Herald

基　　金：江苏省自然科学基金资助项目(BK20181153)。

摘　　要：目的研究围手术期保温干预对全身麻醉胸腔镜肺手术患者应激反应及并发症的影响。方法选择2019年10月至2022年11月江苏省淮安市第一人民医院收治的胸腔镜肺手术患者110例为研究对象,采用随机数字表法将其分为对照组(55例)和观察组(55例)。对照组围手术期进行常规干预,观察组围手术期在对照组的基础上采用保温干预,两组均观察至患者离开麻醉恢复室。比较两组麻醉前(T_(0))、术后开始60 min(T_(1))、手术结束时(T_(2))、入麻醉恢复室即刻(T_(3))、入麻醉恢复室15 min(T_(4))、出麻醉恢复室(T_(5))时体温;比较两组T_(0)、T_(2)、T_(4)时去甲肾上腺素(NE)、肾上腺素(E)、皮质醇(Cor)水平;观察两组并发症的发生情况。结果整体比较:两组体温时间、组间、交互作用比较,差异有统计学意义(P<0.05)。组内比较:与T_(0)时比较,对照组T_(1)时体温降低;与T_(1)时比较,T_(2)~T_(5)时体温升高,差异有统计学意义(P<0.05)。与T_(0)时比较,观察组T_(1)~T_(5)时体温升高,差异有统计学意义(P<0.05)。组间比较:观察组T_(1)~T_(5)时体温高于对照组,差异有统计学意义(P<0.05)。整体比较:两组NE、E、Cor水平时间、组间、交互作用比较,差异有统计学意义(P<0.05)。组内比较:两组组内不同时间点NE、E、Cor水平两两比较,差异有统计学意义(P<0.05)。组间比较:观察组T_(2)、T_(4)时NE、E、Cor水平低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论围手术期保温干预有助于维持胸腔镜肺手术患者体温,降低患者机体应激反应、术后并发症发生情况,具有较好的干预效果。Objective To investigate the effects of perioperative period thermal insulation intervention on stress response and complications in patients undergoing thoracoscopic lung surgery under general anesthesia.Methods A total of 110 patients with thoracoscopic lung surgery treated in Huaian First People’s Hospital,Jiangsu Province from October 2019 to November 2022 were selected as the study objects,and they were divided into control group(55 cases)and observation group(55 cases)by random number table method.The control group received routine intervention in perioperative period,and the observation group received thermal insulation intervention in perioperative period on the basis of control group.Both groups were observed until the patients left the anesthesia recovery room.The body temperature between two groups was compared before anesthesia(T_(0)),60 min after the operation(T_(1)),at the end of operation(T_(2)),immediately after entering the anesthesia recovery room(T_(3)),15 min after entering the anesthesia recovery room(T_(4)),and at the exit of the anesthesia recovery room(T_(5));the levels of norepinephrine(NE),epinephrine(E),and cortisol(Cor)at T_(0),T_(2),and T_(4)were compared between two groups;the occurrence of complications in two groups was observed.Results Overall comparison:there were statistically significant differences in body temperature time,inter-group,and interaction between two groups(P<0.05).Intra-group comparison:compared with T_(0),the body temperature of control group decreased at T_(1);compared with T_(1),the body temperature was increased at T_(2)-T_(5),and the differences were statistically significant(P<0.05).Compared with T_(0),the body temperature of observation group was increased at T_(2)-T_(5),and the differences were statistically significant(P<0.05).Comparison between groups:the body temperature of observation group at T_(1)-T_(5)was higher than that of control group,and the difference was statistically significant(P<0.05).Overall comparison:there were statistically significa

关 键 词：胸腔镜 围手术期 保温干预 应激反应 并发症 

分 类 号：R568[医药卫生—呼吸系统]