椎管内麻醉后寒战的影响因素及临床治疗分析

Analysis of the influencing factors and clinical treatment of shivering after spinal anesthesia

目的分析椎管内麻醉后寒战的影响因素,并探讨临床治疗手段及效果。方法从2014年7月10日至2016年7月10日在本院进行治疗的椎管内麻醉患者中随机选取90例作为研究对象,根据患者是否出现寒战将其分为寒战组与非寒战组,其中寒战组48例,非寒战组42例,对比两组患者的基本情况、麻醉方式、术中出血量以及手术时间。将寒战组48例患者随机分为对照组和治疗组,各24例。对照组患者给予布托啡诺治疗,治疗组给予盐酸曲马多治疗,对比两组患者的临床疗效。结果寒战组与非寒战组患者的平均年龄、性别、手术时间和术中出血量、麻醉方式比较,差异具有统计学意义(P<0.05)。治疗组患者的临床总有效率(91.67%)稍微优于对照组(87.50%),但两组间比较,差异没有统计学意义(P>0.05)。结论椎管内麻醉患者是否发生寒战与年龄、性别、麻醉方式、手术时间和术中出血量有关,针对椎管内麻醉后寒战患者,及时给予盐酸曲马多或布托啡诺等药物治疗能够取得良好的临床效果。

Objective To analyze the influence factors of shivering after spinal anesthesia, and explore the clinical treatment methods and effects. Methods From July 10, 2014 to July 10, 2016, 90 spinal anesthesia patients admitted in our hospital were randomly selected as the study objects. All the patients were divided into shivering group （n=48） and nonshivering group （n=42） according to whether occurred shivering or not; the basic situation, type of anesthesia, intraoperative blood loss and operation time were compared between the two groups. Forty-eight patients in the shivering group were ran- domly divided into control group and treatment group, with 24 cases in each group. The control group was treated with bu- torphanol, and the treatment group was given tramadol hydrochloride, the clinical effects of the two groups were compared. Results There were significant differences on the patients＇ age, sex, operation time, intraoperative blood loss and type of anesthesia between shivering group and nonshivering group （P〈0.05）. The total effective rate of the treatment group was 91.67%, which was better than 87.50% of the control group, but the difference between the two groups was not statistically significant （P〉0.05）. Conclusion The incidence of shivering in patients undergoing spinal anesthesia is related to age, sex, type of anesthesia, operation time and intraoperative blood loss. For patients with shivering after spinal anesthesia, the treatment of tramadol hydrochloride or butorphanol in a timely manner can achieve good clinical effects.