术前联合加温对腹部大手术患者体温及苏醒质量的影响

Effect of preoperative combined warming strategy on body temperature and recovery quality in patients undergoing major abdominal surgeries

目的探讨术前联合加温护理策略对腹部大手术患者体温及苏醒质量的影响.方法选择宁波市第二医院择期在全身麻醉下行腹部大手术患者60例,根据在术前准备室采取不同加温策略随机分为2组:加温毯复合输液加温组(联合组)和常规棉被加温组(常规组),各30例.2组患者在术前准备室停留时间至少30 min.记录和比较2组患者一般临床资料、手术时间、液体总出入量、术中各时间点体温变化及苏醒期相关不良事件.结果2组患者手术时间、术中总的出入量、麻醉拔管时间、引流量和躁动发生率比较均无统计学差异(P>0.05);2组患者T0时体温相比较,无显著差异;与T0时体温比较,常规组患者T2-T6时体温明显降低,联合组患者T1-T2时体温明显升高,差异有统计学意义(P<0.05);与T1时体温比较,常规组患者T2-T6时体温明显降低,联合组患者T3-T6时体温明显降低,差异有统计学意义(P<0.05);与联合组相比较,常规组患者T1-T6时间点体温明显降低,术中低体温和苏醒期寒颤的发生率明显增加,差异有统计学意义(P<0.05).结论实行术前联合加温护理策略,可显著预防腹部大手术患者低体温的发生,提高苏醒质量,值得临床推广应用.

AIM To explore the effects of preoperative combined warming strategy on body temperature and recovery quality in patients undergoing major abdominal surgeries.METHODS Sixty patients scheduled for elective major abdominal surgeries under general anesthesia were randomly divided into either a control group（n = 30） or an observation group（n = 30）. The preoperative combined warming strategy consisting of warming blanket and infusion warming was applied in the observation group, while quilt warming was applied in the control group. All patients stayed in the preoperative preparation room for at least 30 min. Data recorded and compared between the two groups included general clinical information, the total time of operation, total fluid infusion and output volume, the change of body temperature at various time points, and the adverse events related to recovery period.RESULTS There was no significant difference in operative time, total fluid infusion and output volume, anesthesia extubation time, amount of drainage, incidence of restlessness, or body temperature at T0 between the two groups. Compared with baseline body temperature at T0, the temperatures at T2-T6 were significantly lower in the control group, while the temperature at T1-T2 wassignificantly higher in the observation group. Compared with body temperature at T1, the temperatures at T2-T6 in the control group and those at T3-T6 in the observation group were significantly lower（P 0.05）. Compared with the observation group, the temperatures at T1-T6 in the control group were significantly lower, and the incidence rates of intraoperative hypothermia and postoperative shivering were significantly increased（P 0.05）.CONCLUSION Preoperative combined warming strategy can significantly prevent the occurrence of hypothermia and improve the quality of recovery in patients undergoing major abdominal surgery.