术中保温对胰十二指肠切除患者凝血功能的影响

目的观察术中保温措施对胰十二指肠切除患者凝血功能的影响。方法将50例择期行胰十二指肠切除术患者随机分为对照组和观察组，每组各25例。对照组按常规进行手术；观察组采取输液加温器对输入液体进行加温；充气温控毯加强躯体保温，冲洗液微波炉加温处理，两组患者分别于麻醉前，手术开始后30、60、90、180min及术毕测量患者食管下段体温及凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）。结果随着手术的进行，不同时间的体温及凝血指标比较，差异有统计学意义（P均〈0．05）。对照组手术开始后至结束时体温下降，PT、APTT延长，观察组波动较小，两组比较差异有统计学意义（P均〈0．05）。结论胰十二指肠切除术中保温措施可维持患者的体温及凝血功能。

Objective To explore the role of heat preservation on coagulation function in patients with pancreaticoduodenectomy. Methods A total of 50 patients who underwent elective pancreatoduodenectomy were randomly divided into control group and observation group （ n=25 each ） . The control group was operated by routine. While, three kind of measures used infusion warmer to heat the input liquid combined with the use of the inflatable blanket to enhance the insulation of the body and the use of microwave to warm the rinsing solution, were packed with the patients in observation group to keep warm. The temperature of the lower esophageal and the levels of thromboplastin and prothrombin time （ PT ） and the activation of partial thromboplastin （ APTT ） were measured at the time of beginning of anesthesia, 30, 60, 90, 180 min after operation and at the end of operation. Results With the progress of surgery, there were significant differences in body temperature of different time and coagulation index between the two groups （ P〈0.05 ） .The body temperature decreased and the levels of PT and APTT were prolonged in the control group at the end of the operation, and that was not the case with the observed group. The difference was statistically significant （ P〈0.05 ） . Conclusion Pancreatoduodenect omy in patients with intraoperative thermal insulation measures can maintain the patient＇s body temperature and coagulation function.