不同术中保温对开腹手术患者低体温及手术部位感染的影响

Effect of different intraoperative insulation methods on hypothermia and surgical site infection in patients with gastrointestinal surgery

目的评价不同术中保温方法对胃肠开腹手术患者低体温及手术部位感染的影响。方法入选胃肠开腹手术患者200例,随机分为对照组和试验组,每组100例。对照组盖被保温,试验组在对照组基础上用充气加温毯保温。比较2组术前、手术开始30,60,90 min及术毕即刻的体温变化,低体温发生率,术前、手术开始30 min及术毕即刻的凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT),术中、术后2,12 h及术后24 h的失血量、手术部位感染发生率。结果手术过程中,试验组患者体温无明显变化,与对照组比较差异有统计学意义(P<0.05)。试验组低体温发生率显著低于对照组(10.0%vs67.0%)(P<0.05)。试验组凝血酶原时间、凝血酶时间、APTT无明显变化,与对照组比较差异有统计学意义(P<0.05)。试验组术后失血量显著低于对照组(P<0.05)。试验组手术部位感染发生率显著低于对照组(3.0%vs 17.0%)(P<0.05)。结论用充气加温毯对胃肠开腹手术患者术中保温,可利于维持体温稳定,降低低体温发生率,改善凝血功能,减少失血量及手术部位感染发生率。

Objective To evaluate the effect of different intraoperative insulation methods on hypothermia and surgical site infection in patients with gastrointestinal surgery. Methods A total of 200 patients with gas- trointestinal surgery were randomly divided into control group （ n = 100） and experiment group （n = 100）. The patients in control group were given to cover with quilts. The experiment group patients were given to cover with quilts combined with inflatable warm. The body temperature changes, hypothermia rate, prothrombin time （PT）, thrombin time （TY）, activated partial thromboplastin time （APTT）, bleeding volume and surgical site infection rate were compared between the two groups. Results In the process of operation, the body temperature of observation group had no obvious change, but compared with the control group, significantly different （ P 〈 0. 05 ）. The hypothermia rate of experiment group significantly lower than that of control group （ 10.0% vs 67.0% ） , （P 〈 0.05 ）. The PT, AFVF and TF of experiment group had no obvious change, statistically different from those of the control group （ P 〈 0.05 ）. The bleeding volume of experiment group significantly less than control group （P 〈0.05）. The surgical site infection rate of experiment group significantly lower than that of control group （ 3.0% vs 17.0% , P 〈 0. 05 ）. Conclusion Using inflatable warm nursing on patients with gastrointestinal surgery can effectively maintain body temperature, decrease hypothermia, improve coagulation function, reduce bleeding volume and surgical site infection rate.