术中综合保温措施对创伤病人体温和麻醉复苏时间的影响

The effect of integrated thermal insulation measures during surgery on trauma patients' temperature and anesthesia recovery time

目的探讨术中综合保温措施对创伤病人体温和麻醉复苏时间的影响。方法选择2014年1—12月在我院收治的创伤急诊手术病人64例随机分为观察组和对照组各32例。对照组病人术中予以常规护理;观察组病人予以综合保温措施,包括人体保温、调整室温、术野覆盖无菌薄膜、输注加温液体等措施。观察两组病人麻醉诱导前、手术开始后30 min及2 h、手术结束时、术后1 h、术后3 h的鼻咽腔温度。观察并记录两组病人术后睁眼时间,气管拔管时间,离室时间以及寒颤、躁动的发生率。结果两组病人麻醉诱导前鼻咽腔温度差异无统计学意义(P>0.05),开始手术后各时间点观察组鼻咽腔温度高于对照组,差异均具有统计学意义(P<0.05)。两组病人术后躁动发生率差异无统计学意义(P>0.05);观察组病人术后睁眼时间,气管拔管时间、离室时间、以及寒颤发生率的值均低于对照组,差异具有统计学意义(P<0.05)。结论术中对创伤病人采用综合保温措施,能够更好地维持病人体温恒定,缩短病人麻醉复苏时间,提高麻醉复苏质量。

Objective To probe into the influence of integrated thermal insulation measures during the surgery on body temperature and anesthesia recovery time for trauma patients. Methods 64 cases of trauma emergency surgery patients,those who got treatment in our hospital during January 2014 and December 2014,they were randomly divided into observation group and control group（ n = 32）. Patients in the control group received intraoperative conventional process,however,patients in observation group adopted comprehensive heat preservation,which includes measures such as human body heat preservation,adjusting the room temperature,covering sterile membrane on operation field,infusion heating liquid. To observe nasopharyngeal temperature of the two groups of patients at six different time points- before anesthesia induction,30 minutes and 2 hours after the start of the operation,the end of the surgery and postoperative 1 hours and 3 hours. Observed and recorded some indicators of two groups of patients,including the open time,postoperative tracheal extubation time,time away from the office,and the incidence of postoperative shivering and agitation. Results The difference of nasopharyngeal temperature between the two groups of patients before induction had no statistical significance（ P〉0. 05）,after the start of the surgery,nasopharyngeal temperature of the observation group was higher than that of the control groups at any time points,and the difference was statistically significant（ P〈0. 05）. The difference of incidence of agitation between the two groups was not statistically significant（ P〉0. 05）. The open time,postoperative tracheal extubation time,time away from the office and the incidence of postoperative shivering and agitation value of the observation group were lower than that of control group,and the difference had statistical significance（ P〈0. 05）. Conclusions The integrated thermal insulation measures helps to maintain a constant body temperature of patients. By the way,the patient＇s anesthesia recovery time can be shortened and the quality of anesthesia recovery can be improved.