Inditherm加温系统在预防前列腺电切术中低体温的临床应用价值

Clinical value of the Inditherm warming system on prevention of hypothermia in patients with TURP

目的探讨Inditherm病员加温系统在预防经尿道前列腺电切（TURP）围术期低体温中的临床应用效果。方法选择52例前列腺增生择期行TURP的老年患者，随机分为两组，观察组27例，对照组25例。观察组患者入手术室后使用病员加温系统，温度设定为38～40℃。对照组患者不采取保温措施，手术室温维持在21—23℃。术中持续监测两组患者肛温变化，记录术中生命体征变化并观察部分术后相关指标。结果麻醉后两组患者体温均开始下降，麻醉后20、30、45、60、90min及术毕各时间点观察组[分别为（36．6±0．4）、（36．4±0．5）、（36．2±0．3）、（36．1±0．4）、（36．0±0．3）、（36．0±0．4）℃]体温下降幅度比对照组[分别为（36．3±0．6）、（35．8±0．4）、（35．5±0．5）、（35．3±0．4）、（35．3±0．6）、（35．3±0．5）℃]明显减小（t值分别为2．1362、4．7536、6．1751、7．2057、5．3818、5．5948，P〈0．05或P〈0．01）；观察组术毕低体温（肛温〈36℃）发生率较对照组显著减少[25．93％（7／27）与92．00％（23／25），χ^2=23．218，P〈0．01]，观察组术毕寒战发生率较对照组显著减少[14．81％（4／27）与64．00％（16／25），χ^2=13．267，P〈0．01]。术后疼痛显著减轻，VAS评分观察组为（2．45±1.88）分、对照组为（3．79±1．63）分，差异有统计学意义（t=2．7362，P〈0．01），住院时间缩短[（5．37±2．31）d与（7．13±3．06）d，t=2．3518，P〈0．05]。结论围术期使用Inditherm病员加温系统能有效预防老年患者TURP术中低体温的发生，减少相关并发症。

Objective To evaluate the effectiveness of Inditherm warming system on prevention of intraoperative hypothermia in aged patients with transurethral resection of the prostate （TURP）. Methods Fifty two aged patients with benign prostate hyperplasia（BPH） undergoing selective TURP were randomly divided into two groups ： observation group （ n = 27 ） and control group （ n = 25 ） . Patients in observation group received temperature prevention from hypothermia by using the patient warming system which temperature was set to 38 - 40 ℃. The control group were not provided with warming mattress and the ambient temperature of operation room was maintained at 21 - 23 ℃. The changes of the rectal temperature were continuously monitored during the operation and changes of vital signs, part of postoperative indicators were observed. Results The temperature of patients in both groups decreased after anesthesia. The decreasing degree of rectal temperature at 30,45,60, and 90 min after anesthesia and at the end of operation in observation group was less than those in control group [ 20 min： （36.6±0.4） ℃ vs（36. 3 ±0. 6）℃ ,t =2. 1362;30 min： （36.4 ±0.5）℃vs（35.8 ±0. 4）℃ ,t =4.7536; 45 min：（36.2 ±0.3）℃ vs（35.5 ±0.5）℃ ;t =6. 1751;60 min： （36. 1 ±0.4）℃ vs（35.3 ±0.4）℃,t = 7. 2057 ;90 min： （36. 0 ± 0. 3 ） ℃ vs （ 35.3 ± 0. 6 ） ℃, t = 5. 3818 ; at the end of operation ： （ 36. 0 ± 0. 4 ） ℃ vs （ 35.3 ± 0. 5 ） ℃, t = 5. 5948 ; P 〈 0.05 or P 〈 0. 01 ]. The occurrence rate of hypothermia （ rectal temperature 〈 36 ℃ ）after operation in observation group was lower than that in control group [ 25.93% （7/27）vs 92.00% （23/25） ,χ^2 = 23. 218, P 〈 0. 01 ] ;The occurrence rate of shiver was significantly lower in observation group than that in control group [ 14. 81% （4/27） vs 64. 00% （ 16/25 ）, χ^2 = 13. 267, P 〈 0. 01 ]. The VAS scores assessment of pain in the observation group was significantly less than that in the control group[ （2. 45 ± 1.88 ） points vs（3.79 ± 1.63 ） points, t = 2. 7362, P 〈 0.01 ]. The length of stay was shorten [ （ 5.37 ± 2. 31 ） d vs （7. 13 ± 3.06） d, t = 2. 3518, P 〈 0. 05 ] and the prognosis was better in observation group. Conclusion The patient warming mattress can effectively prevent the occurrence of hypothermia of aged patients undergoing TURP and reduce the occurrence of associated complication.