脑肿瘤手术患者充气加温毯给予时机研究

The study of timing of force-air warming blanket on patient during brain tumor surgery

目的 :通过对比充气加温毯的不同给予时机,观察其对脑肿瘤手术患者体温及并发症的影响。方法 :将83例脑肿瘤手术患者随机分为两组,干预组41例在患者进入手术间时立即给予普通毛毯+充气加温毯加温,对照组42例在进入手术间时给予普通毛毯,麻醉诱导时给予充气加温毯加温,观察两组患者围手术期体温、术中出血量、术后寒战发生率、苏醒期躁动发生率、麻醉苏醒时间、切口感染发生率。结果 :干预组麻醉诱导时、麻醉1.5h、麻醉结束时体温均高于进入手术间时,体温差异均有统计学意义(P<0.05);对照组麻醉诱导时到麻醉1.5h的体温均低于进入手术间时,差异均有统计学意义(P<0.05);干预组从麻醉诱导时到麻醉结束时各时间点体温均高于对照组,体温差异均有统计学意义(P<0.001);干预组寒战发生率、躁动发生率及麻醉苏醒时间均低于对照组,差异有统计学意义(P<0.05)。结论 :脑肿瘤手术患者进入手术间时应立即给予充气加温毯加温,并且要注意适当的温度档位调节,从而能够减少围手术期低温的发生,降低术后并发症的发生。

Objective： To observe the effect of forced-air warming blanket application timing on patient＇s temperature and complication during brain tumor surgical operation. Methods： We collected 83 brain tumor surgery cases, and then randomly divided into two groups. The treatment group （n=41） was applied ordinary blanket and forced-air warming blanket immediately after the patients were sent into the operating theatre. The patients in the control group （n=42） were given the ordinary blanket when they were into the operating theatre, but given the forced-air warming blanket only when the narcotic induction started. We examined and compared two groups of patients on perioperative body temperature, intraoperative blood loss, postoperative incidence of chills, awakening agitation rate, anesthesia duration, incision infection risk. Results： The patients＇ body temperatures in the treatment group were higher than the entries when compared at the watching points： the induction, 1.5hour, end of anesthesia respectively. The temperature difference had statistical significance （P〈0.05）. The patients＇ body temperatures in the control group were statistically significantly lower than the entries at each watching point except the end of anesthesia （P〈0.05）. The temperatures in the treatment group from anesthesia induction to the end were higher than the parts in the control group with statistical significance （P〈0.001）. The incidence of awaken chills, agitation and anesthesia duration was statistically significantly lower in the treatment group than in the control group （P〈0.05）. Conclusion： This study suggests that forced-air warming blanket should be applied to patients immediately when they enter into operating theatre before brain tumor surgery starts.