加温碘伏消毒对老年乳腺癌根治手术中体温及出血的影响  

Effects of heated iodophor disinfection on body temperature and bleeding in elderly patients undergoing radical mastectomy

作　　者：谭珊珊 韩笑[1] 何文文 刘琼[1] 田振 TAN Shan-shan;HAN Xiao;HE Wen-wen;LIU Qiong;TIAN Zhen(Department of Anesthesia and Surgery,Suqian Hospital of Jiangsu Provincial People's Hospital,Suqian Jiangsu 223800,China;Department of Anesthesiology,Nanjing Drum Tower Hospital Group Suqian Hospital,Suqian Jiangsu 223800,China)

机构地区：[1]江苏省人民医院宿迁医院麻醉手术科,江苏宿迁223800 [2]南京鼓楼医院集团宿迁医院麻醉科,江苏宿迁223800

出　　处：《局解手术学杂志》2025年第3期241-244,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：江苏省宿迁市科技指导计划(Z2019179)。

摘　　要：目的明确加温碘伏消毒对老年乳腺癌根治手术患者术中体温及出血的影响。方法选择2022年9月至2024年8月于江苏省人民医院宿迁医院行单侧乳腺癌根治手术的78例老年患者为研究对象,随机分为对照组和观察组,每组39例,分别采用23℃碘伏和加温至37℃的碘伏进行术前皮肤消毒。对2组患者的皮肤消毒合格情况、切口感染情况、体温、苏醒期不良反应、术中出血量、术后引流血量和血红蛋白水平进行比较。结果2组患者的皮肤消毒合格率和切口感染率比较差异均无统计学意义(P>0.05)。在消毒后30 min、消毒后60 min及手术结束时,观察组患者的体温均明显高于对照组(P<0.05)。观察组患者的术中低体温、苏醒延迟和寒战反应发生率均明显低于对照组(P<0.05)。观察组患者的术中出血量和术后引流血量均明显少于对照组(P<0.05)。术后3 d,观察组患者的血红蛋白水平明显高于对照组(P<0.05)。结论与常规使用23℃碘伏对行乳腺癌根治手术的老年患者进行皮肤消毒相比,使用加温至37℃的碘伏消毒并不影响消毒效果和切口感染情况,且患者术中低体温发生率更低,有利于减少术中出血量,降低苏醒期不良反应发生率。Objective To determine the effects of heated iodophor disinfection on intraoperative body temperature and bleeding in elderly patients undergoing radical mastectomy.Methods A total of 78 elderly patients who underwent unilateral radical mastectomy in Suqian Hospital of Jiangsu Provincial People's Hospital from September 2022 to August 2024 were selected as the study subjects,and they were randomly divided into the control group and the observation group,with 39 cases in each group.The control group and the observation group were disinfected with iodophor at temperature of 23℃and heated to 37℃before surgery,respectively.The qualified skin disinfection,incision infection,body temperature,adverse reactions during the recovery period,intraoperative bleeding volume,postoperative drainage bleeding volume,and hemoglobin levels of patients of the two groups were compared.Results There was no statistically significant difference in the qualified rate of skin disinfection or incision infection rate between of patients the two groups(P>0.05).At 30 minutes after disinfection,60 minutes after disinfection,and at the end of surgery,the body temperature of patients in the observation group was significantly higher than that in the control group(P<0.05).The incidences of intraoperative hypothermia,delayed awakening,and shivering reaction of patients in the observation group were significantly lower than those in the control group(P<0.05).The intraoperative bleeding volume and postoperative drainage bleeding volume of patients in the observation group were significantly lower than those in the control group(P<0.05).The hemoglobin level 3 days after surgery of patients in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Compared with the routine use of 23℃iodophor to disinfect the skin of elderly patients undergoing radical mastectomy,the use of iodophor heated to 37℃does not affect the disinfection effect and incision infection,and the incidence of intraoperative hypothermia

关 键 词：加温碘伏 乳腺癌根治术 老年患者 体温 出血 

分 类 号：R187[医药卫生—流行病学]