复合保温对卵巢囊肿腹腔镜手术病人应激反应的影响

The influence of compound incubation to the patients＇stress reaction in ovarian cyst laparoscopic operation

目的探讨复合保温对卵巢囊肿腹腔镜术手术疗人应激反应的影响。方法选择择期行腹腔镜卵巢囊肿切除术患者80例，随机分为A、B两组。其中A组为复合保温组（实验组），B组为常规保温组（对照组），每组40例。分别记录入室、气腹前10min、气腹后10rain、术毕、术后3h的鼻咽温度、SBP、DBP、HR数值。结果①两组病人年龄、性别、体重、气腹压力、气腹时间、输液量、冲洗量、室温等组间比较差异无统计学意义。②术后A组麻醉复苏时间短，组间比较差异有统计学意义。③两组病人入室鼻咽温度基础值比较差异无统计学意义，术中A组鼻咽温度变化不明显，各时间点与入室相比差异无统计学意义，而B组在气腹后10min开始明显下降，气腹后、术毕、术后与入室相比差异有显著意义（P〈0．01），气腹后、术毕、术后A组的温度明显高于B组（P〈0．05）。④两组病人入室的收缩压、舒张压、心率比较差异无统计学意义（P〈0．05），收缩压、舒张压、心率气腹后明显升高、术毕仍未恢复正常水平与入室相比差异有统计学意义。但A组变化幅度小，B组变化的幅度大，组间比较，各项指标气腹后、术毕B组比A组有显著增高（P〈0．05）。且术后心率B组与A组相比差异有统计学意义。结论围手术期患者应用复合保温措施有利于维持卵巢囊肿腹腔镜手术中体温的稳定，减轻腹腔镜手术中的应激反应。

Objective To estimate the influence of compound incubation to the patients＇stress reaction during the ovarian cyst lapuroscopic operation. Methods Ovarian cyst laparoscopic 80 patients were choosen which included A and B grougs. A group was in compound incubation （experimental group） and B group was in normal incubation （control group）, each had 40 patients. Nasopharyngeal temperature, systolic blood pressure （SBP）, diastolic blood pressure （DBP） , heart rate （HR） on these time sahe entering room time （after entering 10 minutes）, 10 minutes before pneum operitoneum, 10 minutes after pneumoperitoneum, the finishing time of operation （without pneumoperiteneum 5 minutes） and 3 hours after operation of two groups were recorded. Results （1）The patients in the two groups were non -statistic difference in age, body weight, the time of pneumoperitonerm, the volume of transfusion and douche, and room temperature, and there were comparability between the two groups. （2）After operation, the patients in group A had shorter palinesthosia -time and less shakes than those in groep B, and there were statistic difference on these. （3）There were non -statistic difference in the two groups＇temperature of epipharynx at the entering room time, the patients in group A changed little at others time points, but the temperature of epipharynx of the patients in group B was decreased obviously at the time ＂ 10 minutes after pneumoperitoneum＂, and there were obvious statistic difference at these points ： 10 minutes after pneumoperitoneum, the finishing time of operation and 3 hours after operation with the entering room time, and the other points were not. The temperatures of the patients in group A were obviously higher than those in group B at these points： 10 minutes after pneumopefitoneum, the finishing time of operation and after operation. （4）There were non - statistic difference in the ertering timeSBP, DBP and HR between the two groups. The changes in group A were few, but their SBP, DBP and HR were become higher after pneumoperitoneum, and the SBP, DBP were not normal level to entering＇s, there were non -statistic difference in the HR between the two points ： after operation and entering time. There were non - statistic difference between other points and entering time. The changes in group B were great, there were obvious statistic difference in SBP, DBP and HR between the points after pneumoperitoneum, after operation and entering time, also the HR between after operation time and the entering time, and others time points were non - statistic, each item at the two points： after pneumoperitoneum time and after operation time in group B were much higher than those in group A, and the HR in the two groups after operation time were obviously different. Conclusions Using compound incubaion, the temperature is kept constantly and the patients＇ stress reaction is reduced during the ovarian cyst laparoseopic operation.