术中体温控制结合术后快速康复外科模式对剖宫产孕妇围术期体温、舒适度的影响  

Influence of intraoperative temperature management combined with enhanced recovery after surgery on perioperative temperature and comfort in cesarean section patients

作　　者：付昱 陈悦 樊云 李鑫 王猛 Fu Yu;Chen Yue;Fan Yun(Department of Obstetrics and Gynecology,No.9 People's Hospital of Wuxi,Wuxi 214000,China)

机构地区：[1]无锡市第九人民医院妇产科,214000 [2]无锡市第九人民医院麻醉科,214000

出　　处：《中华保健医学杂志》2024年第5期655-658,共4页Chinese Journal of Health Care and Medicine

基　　金：无锡市卫生健康委妇幼健康适宜技术推广项目(FYTG202206)。

摘　　要：目的观察术中体温控制结合术后快速康复外科模式对剖宫产孕妇围术期体温、舒适度的影响。方法回顾性选取2020年8月~2023年2月于无锡市第九人民医院采取术中体温控制结合术后快速康复外科模式干预的100例剖宫产孕妇作为体温控制组,另选取年龄、孕周、剖宫产手术时间相匹配而采用术中常规保温结合术后快速康复外科模式干预的100例剖宫产孕妇作为常规保温组。比较两组产妇围术期体温、术中和术后一般情况、热舒适度情况。结果体温控制组产妇胎儿娩出、手术结束时及进入麻醉恢复室10、30和60 min时的体温均高于常规保温组产妇(t=11.916、19.586、40.969、20.827、11.722,P<0.05)。体温控制组产妇术中低体温、颤抖的发生率均低于常规保温组,差异均有统计学意义(χ^(2)=38.281、17.786,P<0.05)。体温控制组产妇术后感染及不良事件总发生率均低于常规保温组,差异均有统计学意义(χ^(2)=4.031、4.735,P<0.05)。体温控制组产妇对热度感觉刚好的发生率高于常规保温组,感觉冷的发生率低于常规保温组,差异均有统计学意义(χ^(2)=19.187、15.273,P<0.05)。结论术中体温控制结合术后快速康复外科模式可稳定剖宫产孕妇围术期体温,减少术中低体温、颤抖和术后感染的发生,提高舒适度。Objective To assess the impact of intraoperative temperature control integrated with an enhanced recovery after surgery(ERAS)protocol on perioperative temperature and comfort levels in patients undergoing cesarean section.Methods A retrospective analysis was conducted on 100 cesarean section patients at Wuxi Ninth People's Hospital from August 2020 to February 2023,who received intraoperative temperature control combined with ERAS postoperatively,and were designated as the temperature control group.Another 100 cesarean section patients,matched for age,gestational age,and duration of surgery,who received standard intraoperative warming combined with ERAS postoperatively,were designated as the conventional warming group.Perioperative temperature,intraoperative and postoperative conditions,thermal comfort,and perioperative inflammatory markers were compared between the two groups.Results The temperature control group had significantly higher body temperatures at the time of fetal delivery,surgery completion,and at 10,30,and 60 minutes after entering the post-anesthesia care unit compared to the conventional warming group(t=11.916,19.586,40.969,20.827,11.722;P<0.05).The incidence of intraoperative hypothermia and shivering was significantly lower in the temperature control group than in the conventional warming group(χ^(2)=38.281,17.786;P<0.05).Postoperatively,the rates of infection and adverse events were also significantly lower in the temperature control group(χ^(2)=4.031,4.735;P<0.05).A higher proportion of patients in the temperature control group reported feeling comfortably warm,while a lower proportion felt cold compared to the conventional warming group(χ^(2)=19.187,15.273;P<0.05).Conclusion Intraoperative temperature control combined with ERAS can stabilize perioperative body temperature,reduce the incidence of intraoperative hypothermia and shivering,and enhance comfort in patients undergoing cesarean section.

关 键 词：体温控制 快速康复外科模式 剖宫产 体温 舒适度 

分 类 号：R714[医药卫生—妇产科学]