湿热交换过滤器预防术中病人低体温的临床研究

Heat and moisture exchanger and filter used for preventing intraoperative hypothermia

目的 探讨湿热交换过滤器 (heatandmoistureexchangerandfilter ,HMEF)预防术中全麻病人低体温的临床应用价值。方法 择期颅脑手术的成年病人 60例 ,随机分为A、B两组 ,每组3 0例。置入直肠温度探测头接DatexⅡ型多功能监测仪持续监测体温。观察组 (A组 )在气管导管与呼吸回路间安置HMEF ,对照组 (B组 )则不放置。将两组间体温的变化进行比较。结果 A组在诱导后、术中至术毕体温也有下降 ,但组间各期比较无显著差异 (P >0 0 5 )。B组在诱导后 60分钟时体温下降最为明显 ,为 2 6℃ ,与A组 ( 1 4℃ )同期比较有非常显著差异 (P <0 0 1)。术毕寒战发生率两组间相比也有显著差异 (P <0 0 5 )。

Objective To evaluate the clinical use of heat and moisture exchanger and filter (HMEF) for preventing intraoperative hypothermia during general endotracheal anesthesia.Methods Sixty ASA physical status of Ⅰ Ⅱ adults patients undergoing selective craniotomy were randomly divided into two groups:abservation group (group A, n= 30) and controlled group (group B, n= 30).All intravenous fluids administered were not warmed in both groups.The body mean temperature was measured by a rectal temperature probe.HMEF was inserted between the endotracheal tube and the breathing circuit in group A,but not in group B.The operating room temperature was controlled at (22±0 5)℃.Results During aneasthesia and surgery,the rectal temperature decreased but there were no significant differences between each periods in group A ( P> 0 05).The decrease was greater in group B.The lowest decrease occurred at 60 min after induction of aneasthesia.The temperature fell 2 6℃ in group B and 1 4℃ in group A.There were statistically significant differences between the two groups ( P< 0 05, P< 0 01).27% patients shivered in group A after anesthesia and 50% controls shivered in group B.There were significantly difference in two group too ( P< 0 05).Conclusion The HMEF can prevent intraoperative hypothermia during general anesthesia.