手术中后期复合保温措施对颅脑手术患者低体温和不良反应的影响

Effect of compound heat preservation in middle and late operation on hypothermia and adverse reaction of patients undergoing craniocerebral operation

目的 探讨手术中后期进行复合保温对颅脑手术患者手术中体温和术后不良反应的影响.方法 选择2014年6月-2016年1月在北京某三甲医院行择期全麻颅脑手术患者150例,应用区组随机的方法分为对照组和观察组,每组75例.对照组患者手术过程中采用常规保温措施;观察组在常规保温措施基础上,在手术中后期采取复合保温措施.比较两组患者术后低体温及不良反应（寒战、躁动、心率加快）的发生情况.结果 两组患者在手术中均出现中心体温的下降,达轻度低体温状态（35-36 ℃）.观察组患者在实施复合保温措施后,气管拔除时间、完全清醒时间为（22.24±6.23）、（42.58±9.84） min,寒战、躁动、心率加快发生例数分别为4、5、8例,对照组气管拔除时间、完全清醒时间为（37.45±5.89）、（72.24±8.92） min,寒战、躁动、心率加快发生例数分别为30、35、25例,差异均有统计学意义（t/χ2值分别为3.897、4.546、25.710、30.682、11.228;P〈0.01）.结论 对颅脑手术患者行手术中后期的复合保温措施,可改善患者的术后低体温状态,减少术后恢复期的不良反应.

Objective To explore the effect of compound heat preservation in late operation on intraoperative hypothermia and postoperative adverse reaction of patients undergoing craniocerebral operation. Methods From June 2014 to January 2016, 150 patients undergoing general anesthesia and craniocerebral operation in a Class Ⅲ Grade A hospital in Beijing were selected as the research object. They were divided into control group and observation group by the random method of region group, with 75 cases in each group. Patients in the control group received routine heat preservation during the operation, and patients in the observation group received compound heat preservation in the middle and late period of operation on the basis of routine method. The incidence of postoperative hypothermia and adverse reactions （chill, restlessness and heart rate expedited） were compared between the two groups. Results The two groups of patients showed a decrease in core body temperature during the operation, reaching a mild hypothermia state （35-36 ℃）. After the implementation of compound heat preservation, tracheal extubation time and total wakefulness time in the observation group were （22.24±6.23） and （42.58±9.84） min, and the number of chills, restlessness and heart rate increased were 4, 5 and 8 cases respectively. The time of tracheal extubation and full wakefulness in the control group were （37.45±5.89） and （72.24±8.92） min, and the number of chills, restlessness and heart rate increased were 30, 35, 25 cases respectively. The differences were statistically significant （t/χ2=3.897, 4.546, 25.710, 30.682, 11.228; P〈0.01）. Conclusions Compound heat preservation measures during operation in patients with craniocerebral operation can improve postoperative hypothermia and reduce adverse reactions in postoperative recovery.