小儿心脏手术围术期的体温变化与探讨

Observation and Evaluation of Intra-operative Temperature in Children Undergoing Cardiac Surgery

目的观察并分析小儿心脏手术期间的体温变化。方法对58例体外循环患儿持续监测鼻咽温度和直肠温度,分别在麻醉诱导后,体外循环前,体外循环后和手术结束时记录数据。结果围术期间鼻咽温度和直肠温度发生显著变化。体外循环前鼻咽温度和直肠温度呈高度相关,但体外循环结束这种相关性消失。结论选择合适的体温监测位置能减少脑部温度过高的危险性。心脏手术中应该持续体温监测和积极外周保暖并控制好复温速度,这样才能避免脑部温度过高带来的潜在危险。

Objective To observe and evaluate temperature changes in children undergoing cardiac surgery. Methods 58 children undergoing cardiopulmonary bypass（CPB） were monitored continuously with a nasal and rectal temperature probes. The data were recorded after induction of anesthesia, before CPB, off CPB and the end of surgery,respectively. Results There were significantly changes in nasal and rectal temperatures during the intra- operative period. Before CPB, nasal temperature was found to be highly correlated with the rectal temperature. However, after CPB, no relationships between the nasal temperature and the rectal temperatures were demonstrated. Conclusions Selecting the best sites for temperature monitoring can reduce the risk of brain hyperthermia. During cardiac surgery, we should combine continuing temperature monitoring and active peripheral warming in order to carefully control the rewarming process, thus avoiding the potential incidence of cerebral hyperthermia.