充气式加温毯在小儿腹腔镜巨结肠根治术中的应用

Clinical application of inflatable warming blanket in pediatric laparoscopic hirschsprung radical surgery

目的观察充气式加温毯用于小儿腹腔镜巨结肠根治术的临床应用价值。方法选择62例全身麻醉下经腹腔镜行巨结肠根治术的患儿并随机分为两组,充气式加温组入室使用身下型充气式加温毯(F组,n=31),对照组常规保温(C组,n=31),记录围手术期患儿的鼻咽温度,HR、BP、SpO2、ECG、RR,手术开始前和手术结束时的PT、APTT、TT,术后的呼吸恢复时间、拔管时间,并观察术中出血情况和苏醒期的不良反应的发生。结果手术开始后两组患儿体温均有所下降,充气式加温组术中及手术结束时的体温高于对照组,术中血流动力学指标较对照组更为平稳。手术结束后对照组PT、APTT、TT、呼吸恢复时间、拔管时间均较延长,苏醒期寒战和苏醒延迟的发生率亦高于充气式加温组。结论充气式加温毯能有效地预防腹腔镜下行巨结肠根治术患儿术中低体温的发生。

Objective To explore the clinical value of inflatable warming blanket in laparoscopic hirschsprung radical surgery.Methods A total of 62 children with congenital megacolon scheduled for radical laparoscopic operation under general anesthesia were randomly divided into two groups：experiment group and control group.The children were given inflatable warming blanket in experiment group,and conventional insulation in control group.The nasopharyngeal temperature,BP,HR,SpO2,ECG,RR during the operation and PT,APTT,and TT before the operation and at the end of the operation,the postoperative respiration recovery time and extubation time were recorded.The bleeding volume during operation and the incidence of adverse reactions during emergence period were observed.Results The body temperatures in both groups were decreased after the beginning of the operation.The temperature was significantly higher in experiment group than that in control group during operation and at the end of operation（P 〈 0.05）,and the hemodynamic parameters were more steady （P 〈 0.05）.Compared with control group,PT,APTT,TT at the end of operation,the breathing recovery time and the extubation time were shortened in experiment group（P 〈 0.05）.The amount of bleeding and the incidences of shivering in emergence period and delayed recovery were also higher in experiment group than in control group （P 〈 0.05）. Conclusion The inflatable blanket can effectively and safely prevent the incidence of perioperative hypothermia in patients undergoing laparoscopic hirschsprung radical surgery.