加温加湿二氧化碳气腹对腹腔镜妇科手术患者的体温及凝血四项指标的影响

Impact of Warmed and Humidified Carbon Dioxide on Body Temperature and Blood Coagulation during Laparoscopic Gynecologic Surgery

【目的】观察加温加湿CO2气腹对腹腔镜妇科手术患者的影响。【方法】选择行腹腔镜妇科手术患者60例，随机分为两组。A组：低温组，二氧化碳温度为21℃，湿度0％；B组：加温加湿组，二氧化碳加温至37℃，湿度98％；两组患者均建立气腹进行腹腔镜手术。监测比较两组患者在麻醉前、气腹后10min、30min、60min、90min的体温，术前及气腹后60min的凝血常规四项指标值。【结果】术中体温变化：低温组在气腹后体温均比麻醉前降低，且差异有显著性（P〈0．05），两组在气腹后60min、90min比麻醉前降低（P〈0．05），但低温组体温下降的更为明显（P〈0．05）。两组病人术前及气腹后60min的凝血常规四项指标值相比较差异均无显著性（P〉0．05）。【结论】加温加湿CO2气腹可更好的维持患者在术中的体温，且对患者凝血功能常规指标值无明显影响。

[ObjectivelTo Investigate the Impact of Warmed and Humidified Carbon Dioxide on Patients Undergoing Laparoscopic Gynecologic Surgery. [Methods]Sixty female patients undergoing laparoscopic gynecologic surgery were randomly divided into two groups （ n = 30） ： group A received standard gas （19℃, 0% RH） and group B received warmed （37℃） and humidified （98% RH） insufflation carbon dioxide. Body temperature was measured before anesthesia and post-pneumoperitoneum 10 min, 30 min, 60 min, and 90 min and compared between the two groups. Blood coagulation value was observed before surgery and 60 min after pneumoperitoneum. [Results] Intraoperative body temperature change after pneumoperitoneum in group A were lower than before anesthesia （ P〈0.05）. In group B, change 60min and 90 min after pneumoperitoneum were lower than before anesthesia （ P〈0.05）, but change was not as significant in group B as in group A （ P〈0.05）. The two groups of patients showed no significant difference in coagulation value （ P〉0.05）. [Conclusion]Heating and humidifying the carbon dioxide gas can better maintain the temperature of patients in the perioperative and reduce postoperative pain. It has no obvious effect on blood coagulation function in patients.