术中保温应用于全身麻醉腹部手术患者的效果刍议

The Effect of Intraoperative Warming on Patients Undergoing General Anesthesia for Abdominal Surgery

目的探究全身麻醉腹部手术患者采用术中保温措施的临床效果。方法选取的66例全身麻醉腹部手术患者都来自于该院2018年1—9月这一期间,并按照双盲法分为2组,对比组患者不接受保温措施,实验组患者进行充气式升温毯与输液加温器等措施保温。并对两组患者体温、凝血酶原时间、活化部分凝血活酶时间、苏醒时间与术后寒战发生率进行对比。结果对比组术后凝血酶原时间与活化部分凝血活酶时间分别为(15.74±4.74)s、(38.36±5.87)s明显高于手术前的(13.16±4.03)s、(34.40±5.06)s(t1=2.3822,P1=0.0202;t2=2.9353,P2=0.0046);对比组术后体温(35.25±1.81)℃,低于术前的(36.96±2.64)℃(t=3.0689,P=0.0031);实验组术后体温、凝血酶原时间与活化部分凝血活酶时间分别为(36.60±1.34)℃、(13.20±3.45)s、(34.43±5.61)s,与手术前的(36.73±2.29)℃、(13.14±3.20)s、(34.27±5.14)s,对比(t1=0.2815,P1=0.7793;t2=0.0732,P2=0.9118;t3=0.1208,P3=0.9042);手术后实验组与对比组体温、凝血酶原时间与活化部分凝血活酶时间的比较(t1=3.4436,P1=0.0010;t2=2.4889,P2=0.0154;t3=2.7804,P3=0.0071);实验组患者苏醒时间(7.49±1.27)min,明显短于对比组患者的(9.35±1.24)min(t=6.0198,P=0.0000);实验组患者术后寒战发生率0.00%,明显低于对比组患者的21.21%(χ^2=7.8305,P=0.0051)。结论全身麻醉腹部手术患者采用术中保温措施的临床效果显著,可使患者维持正常,使其凝血功能充分改善,减少术后部寒战的出现。

Objective To investigate the clinical effects of intraoperative warming measures in patients undergoing general anesthesia for abdominal surgery.Methods Sixty-six patients with general anesthesia for abdominal surgery were selected from the hospital from January to September 2018.They were divided into two groups according to the double-blind method.The patients in the comparison group did not receive the insulation measures.The inflatable heating blanket and the infusion warmer were insulated.The body temperature,prothrombin time,activated partial thromboplastin time,recovery time and postoperative shiver incidence were compared between the two groups.Results The postoperative prothrombin time and activated partial thromboplastin time were(15.74±4.74)s and(38.36±5.87)s,respectively,which were significantly higher than those before surgery(13.16±4.03)s,(34.40±5.06)s,(t1=2.382 2,P1=0.020 2;t2=2.935 3,P2=0.004 6);postoperative body temperature(35.25±1.81)°C in the comparison group,lower than preoperative(36.96±2.64)°C(t=3.068 9,P=0.003 1).The postoperative body temperature,prothrombin time and activated partial thromboplastin time were(36.60±1.34)°C,(13.20±3.45)s,(34.43±5.61)s,and preoperative(36.73±2.29)°C,(13.14±3.20)s,(34.27±5.14)s,(t1=0.281 5,P1=0.779 3;t2=0.073 2,P2=0.911 8;t3=0.120 8,P3=0.904 2);the temperature of the experimental group and the control group after surgery,prothrombin time and activated partial thromboplastin time comparison(t1=3.443 6,P1=0.001 0;t2=2.488 9,P2=0.015 4;t3=2.780 4,P3=0.007 1).The recovery time of the experimental group was(7.49±1.27)min,which was significantly shorter than that of the control group(9.35±1.24)min(t=6.019 8,P=0.000 0).The incidence of postoperative shivering in the experimental group was 0.00%,which was significantly lower than that of 21.21%of patients in the control group(χ^2=7.830 5,P=0.005 1).Conclusion The clinical effect of intraoperative warming measures in patients undergoing general anesthesia for abdominal surgery is significant,which can keep patients normal,improve their coagulation function,and reduce the occurrence of postoperative chills.