复合保温措施对腹腔镜全子宫切除术病人术中低体温及术后复苏期的影响

Effect of composite insulation measures on the intraoperative low body temperature and postoperative resuscitation in patients treated with laparoscopic hysterectomy

目的:探讨复合保温措施对腹腔镜全子宫切除术病人术中体温及术后复苏期的影响。方法:选择行腹腔镜全子宫切除术病人98例为研究对象,采用随机数字表法分为观察组和对照组,各49例。对照组术中予以传统常规保温护理,观察组术中予以复合保温护理。比较2组不同时间点肛温(入手术室时、麻醉用药停止时、麻醉后30、60、90、120min及手术结束时肛温)、麻醉苏醒时间、拔管时间、躁动发生率和寒战发生率。结果:2组入手术室时肛温比较差异无统计学意义(P>0.05);观察组在麻醉用药停止时、麻醉后30、60、90、120min、手术结束时肛温均显著高于对照组(P<0.01);观察组麻醉用药停止时、麻醉后各时间点及手术结束时肛温均显著高于入手术室时,对照组麻醉后60min之后及手术结束时肛温均显著低于入手术室和麻醉用药停止时(P<0.05~P<0.01)。观察组低体温发生率显著低于对照组(P<0.01)。观察组复苏时间、拔管时间显著短于对照组(P<0.01和P<0.05);观察组躁动、寒战发生率显著低于对照组(P<0.05和P<0.01)。结论:对腹腔镜全子宫切除术病人予以复合保温措施可有效降低术中低体温的发生,促进麻醉复苏,减少躁动、寒战等不良反应的发生。

Objective: To explore the effects of composite insulation measures on intraoperative low body temperature and postoperative resuscitation in patients treated with laparoscopic hysterectomy. Methods: Ninety-eight patients treated with laparoscopic hysterectomy were divided into the observation group and control group according to the random digital table method(49 cases each group).The control group was nursed with traditional heat preservation,and the observation group was nursed with composite heat preservation.The rectal temperature at different time points(including at the time of entering operation room,after anesthesia induction,after 30 minutes,60 minutes,90 minutes,120 minutes of anesthesia induction and at the end of operation),anesthesia recovery time,extubation time,and incidence rates of agitation and shivering between two groups were compared. Results: There was no statistical significance in rectal temperature between two groups at the time of entering operation room( P >0.05).The rectal temperature in observation group was significantly higher than that in control group after anesthesia induction,after 30 minutes,60 minutes,90 minutes,120 minutes of anesthesia induction,and at the end of operation( P <0.01).The rectal temperature in observation group after anesthesia induction,after 30 minutes,60 minutes,90 minutes,120 minutes of anesthesia induction,and at the end of operation was significantly higher than that at the time of entering operation room,and which in control group after 60 minutes of anesthesia induction and at the end of operation was significantly lower than that at the time of entering operation room and end of anesthesia induction( P <0.05 to P <0.01).The incidence rate of hypothermia in observation group was significantly lower than that in control group( P <0.01).The time of anesthesia recovery and extubation in observation group was significantly shorter than that in control group( P <0.01 and P <0.05).The incidence rates of agitation and shivering in observation group were significantly lower than those in control group( P <0.05 and P < 0.01 ). Conclusions: The composite insulation measures in patients treated with laparoscopic hysterectomy can effectively reduce intraoperative low body temperature,promote recovery,and reduce the occurrence of agitation and shivering.