加温输液在神经外科手术中对脑代谢影响的观察

The study of using warmer intravenous infusion in perioperative patients of neurosurgery

目的:探讨加温(37°C)输液在神经外科手术中应用的意义。方法:将60例行开颅肿瘤切除术患者随机分为非加温输液组与加温输液组各30例,分别于全身麻醉诱导后、术中1 h、术中2 h、术中3 h、手术结束即刻测定颈内静脉球部及桡动脉血乳酸含量。结果:两组患者颈内静脉部血乳酸(VL)、动静脉血乳酸差值(ADVL)于术中2 h至术后即刻统计学差异有显著性(P<0.05);两组患者ADVL随手术时间推移而增大,且非加温输液组高于同期加温输液组。结论:围手术期患者应用加温液体输液通过人体正常代谢调节,可保障脑组织的有氧代谢,减少并发症的发生。

Objective： The purpose of this study was to evaluate the usefulness of warmed（37℃）infusion in nerusurgery operation, and to search for a more safe and effective method of transfusion during neurosurgery operation. Method： 60 cases of patients suf- fering from tumors in the brain were operated to resect the tumor. 30 patients in the group of unwarmed transfusion （NWT） were transfused and flushed with fluid of room temperature （22 - 24℃） and covered with carpet; the other 30 patients in the group of warmed-up transfusion （WT）, transfused and flushed with wanned-up fluid of 37℃ and coverd with carpet too. We measured Alc in the blood of internal carotid vein and ralial artery preoperatively, intraoperatively and postoperatively. Result： ADVL of the two groups was augnent with the operation was kept on, and the UWT group was higher than that of the WT group（ P 〈 0.05）. Conclusion： To make warmed-up infusion to perioperative patients in practice can ensure cerebral metabolism.