加温毯不同保温温度对剖宫产手术患者的效果观察

Effect observation of inflatable heating blanket at different temperatures for parturients during cesarean delivery

目的观察将充气式加温毯设置为不同档次的温度为剖宫产产妇进行术中保温对其血压、体温、心率、寒战的影响。方法选择2017年1~9月在广州市妇女儿童医疗中心行腰硬联合麻醉后剖宫产产妇75例,随机分为对照组(A组)、38℃组(B组)和43℃组(C组),对照组为术中被服常规保暖,后两组入室后将充气式加温毯分别设置为相应温度加温。入室后即刻(T0)、麻醉后2 min(T1)、切皮时(T2)、胎儿娩出断脐带时(T3)、手术结束时(T4)五个时间点测血压、心率和体温,记录手术过程出血量及寒战情况,比较组间各指标的差异。结果收缩压在T2、T3、T4时刻B、C组与对照组比较差异有统计学意义(P<0.05);舒张压T4时刻C组与对照组比较差异有统计学意义(P<0.05);三组产妇心率在组间及组内比较差异均无统计学意义;与对照组比较加温两组体温在T2、T3、T4点升高,差异有统计学意义(P<0.05),其中B组术中体温无显著波动;加温两组寒战与对照组相比差异有统计学意义(P<0.05)。结论在腰硬联合麻醉后剖宫产手术中应用加温毯有助于减轻产妇术中血压的波动和寒战的发生,对心率无显著影响;38℃保温档更有助于术中的体温稳定。

Objective To assess the impact of different temperatures of inflatable heating blanket on blood pressure,body temperature,heart rate and chills in parturients during cesarean delivery.Methods The study was conducted from January 2017 to September 2017 in our hospital. Seventy-five parturients scheduled for elective cesarean delivery were randomized divided into three groups：control group（ group A）,38 ℃ group（ group B） and 43 ℃ group（ group C）. The control group was received conventional insulation method with insulation at certain degrees while another two groups were nursed with the inflatable heating blanket setting up corresponding heating temperature,respectively.Blood pressure,body temperature,heart rate,chills and blood loss were recorded when entering the operating room（ T0）,2 minutes after anesthesia（ T1）,incision（ T2）,time of childbirth（ T3） and end of the surgery（ T4）.Results Systolic blood pressure was significantly higher in the group B and C than that in the group A at T2,T3 and T4.Diastolic blood pressure was significantly different between group A and C at T4.No obvious difference of heart rate was found among the three groups.The body temperature was higher in the group B and C than that in the group A at T2,T3,and T4. The incident rate of chills was lower in the group B and C.Conclusion The inflatable heating blanket can reduce the incidence of chills and stabilize the blood pressure for parturients during cesarean delivery,and had no effect on heart rate.The inflatable heating blanket at 38 ℃ can be more helpful to stabilize the temperature during the surgery.