不同保温措施对全麻下经尿道前列腺电切术患者低体温的预防效果  

The Preventive Effect of Different Heat Preservation Measures on Hypothermia in Patients Undergoing Transurethral Resection of Prostate Under General Anesthesia

作　　者：黄冬菱 黄彬彬 陈建霞 HUANG Dongling;HUANG Binbin;CHEN Jianxia(Department of Anesthesiology,No.910th Hospital of China People's Liberation Army Joint Logistics Support Force,Quanzhou 362000,China)

机构地区：[1]中国人民解放军联勤保障部队第910医院麻醉科,泉州362000

出　　处：《中国医药指南》2024年第5期91-94,共4页Guide of China Medicine

摘　　要：目的分析不同保温措施对全麻下经尿道前列腺电切术(TURP)患者低体温的预防效果。方法选取2022年5月—2023年10月期间我科室接收的TURP患者102例,采取随机法中的抓阄法进行分组,分为观察组(n=51)和对照组(n=51)。对照组患者给予常规保温措施,观察组患者给予综合保温措施。结果观察组患者入手术室前(T_(1))、入手术室后持续低流量吸氧时(T_(2))、麻醉成功后5 min(T_(3))时的口腔温度,组间比较差异均无统计学意义(P>0.05)。观察组患者麻醉成功后10 min(T_(4))、术中持续冲洗10 min(T_(5))、持续冲洗30 min(T_(6))、持续冲洗60 min(T_(7))、持续冲洗90 min(T_(8))、冲洗结束时(T_(9))、手术结束时(T_(10)时的口腔温度,均高于对照组(均P<0.05)。观察组患者的低体温发生率(3.92%),低于对照组(13.73%)(P<0.05)。两组患者术前的皮质醇(COR)、去甲肾上腺素(NE)、促肾上腺皮质激素(ACTH)、肾上腺激素(DA)水平,组间比较差异均无统计学意义(均P>0.05)。两组患者气管拔管时的COR、NE、ACTH、DA水平,均低于对照组(均P<0.05)。结论综合保温措施干预可避免TURP患者手术期间体温出现剧烈波动,从而显著降低低体温发生率,从而减轻患者的应激反应。Objective To analyze the preventive effect of different heat preservation measures on hypothermia in patients undergoing transurethral resection of prostate(TURP)under general anesthesia.Methods A total of 102 patients with TURP received in our department from May 2022 to October 2023 were randomly divided into observation group(n=51)and control group(n=51).Patients in the control group were given routine heat preservation measures,while patients in the observation group were given comprehensive heat preservation measures.Results There was no significant difference in oral temperature between the observation group before entering the operating room(T_(1)),after continuous low-flow oxygen inhalation(T_(2))and 5 minutes after successful anesthesia(T_(3))(P>0.05).The oral temperature of patients in the observation group at 10 min after anesthesia(T_(4)),10 min during operation(T_(5)),30 min during operation(T_(6)),60 min after anesthesia(T_(7)),90 min after anesthesia(T_(8)),at the end of irrigation(T_(9))and at the end of operation(T_(10)were significantly higher than those in the control group(P<0.05).The incidence of hypothermia in the observation group(3.92%)was lower than that in the control group(13.73%)(P<0.05).The preoperative cortisol(COR),the levels of norepinephrine(NE),adrenocorticotropic hormone(ACTH)and adrenocorticotropic hormone(DA)had not statistical difference between the two groups(P>0.05).The levels of COR,NE,ACTH and DA during tracheal extubation in the two groups were significantly lower than those in the control group(P<0.05).Conclusions The intervention of comprehensive thermal insulation measures can avoid the drastic fluctuation of body temperature in TURP patients during operation,and reduce the incidence of hypothermia and the stress response of patients.

关 键 词：保温护理 经尿道前列腺电切术 低体温 

分 类 号：R697.3[医药卫生—泌尿科学]