主动充气保温系统预防大手术患者术中低体温的效果

Effectiveness of Underbody Forced-air Warming System in Preventing Hypothermia in Patients Undergoing Major Surgeries

目的评估主动充气保温系统预防大手术患者围手术期低体温的效果。方法 2014年10月至2015年6月在北京协和医院择期行食管癌切除术或全髋关节置换的患者62例,采用随机信封分组法随机分为:(1)研究组(n=30):患者入室后用主动充气保暖系统进行保温;(2)对照组(n=32):用棉毯覆盖方式行传统被动保暖。患者入室后同时采用鼓膜耳温计和SpotOn^(TM)温度感应器连续监测围手术期核心体温变化,直至患者返回病房。结果对照组患者鼓膜温度低体温的发生率为71.87%,明显高于研究组的0(P=0.00);SpotOn^(TM)监测低体温发生率为81.25%,也明显高于研究组的13.33%(P=0.00)。结论与传统保温措施相比,在以食管癌切除术和全髋关节置换术为代表的大型手术中,对患者采取主动充气保温措施可有效预防围手术期低体温的发生。

Objective To compare the effectiveness of the forced-air warming system and the conventional warming care practice in preventing hypothermia in patients undergoing major surgeries. Methods A total of 62 patients were enrolled in this study. Patients of both sexes,aged ≥18 years,and with an ASA physical status Ⅰ-Ⅲ were included and allocated randomly into intervention group（n = 30） or control group（n = 32）.Patients in the intervention group were provided forced-air warming,either prior to induction or during the surgery procedure depending on core temperature monitoring results. In the control group,patients were warmed with conventional warming care without any intervention. Core temperature was measured by Spot-On sensor and tympanic membrane thermometer,blood pressure,the electrocardiogram,heart rate,pulse oxygen staturation,and partial pressure of end-tidal CO_2 were also monitored continuously in the two groups. Crystalloid,colloid,and allogeneic blood were also recorded by strict protocol. Results Intraoperative hypothermia monitored with tympanic thermometer was observed in 23 patients（71. 87%） in the control group,which was significantly higher than that（0） in the intervention group（P = 0. 00）. In addition,the incidence of hypothermia monitored by SpotOn sensor was 81. 25%（n = 26） in control group and 13. 33%（n = 4） in intervention group（P = 0. 00）.Conclusion Compared with the conventional warming care,forced-air warming system is more effective in preventing hypothermia during major surgeries.