液体加温护理在老年患者机器人辅助腹腔镜根治性膀胱切除术中的研究

Beneficial effect of fluid warming in elderly patients with bladder cancer undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy

目的探讨液体加温护理在老年患者机器人辅助腹腔镜根治性膀胱切除术中的研究。方法 108例拟行达芬奇辅助腹腔镜根治性膀胱切除术的膀胱癌患者,随机分入对照组(n=55),术中接受变暖毯加温(41℃),和加温组(n=53),术中接受液体加温(41℃)。比较两组的手术数据、身体温度、凝血功能指标和术后并发症。结果与对照组相比,加温组显著减少了术中输血(P=0.028)和更短的住院天数(P<0.05)。在围术期期间(从1至6 h),加温组体温显著高于对照组。两组患者术前纤维蛋白原(FIB),白细胞(WBC)、总胆红素(total bilirubin)、术中血糖、术后凝血酶原时间(TT)、血小板(PLT)对比具有显著差异(P均<0.05)。多元回归分析证实,TT是唯一的显著因素,这表明加温组具有更低的TT水平。结论液体加温护理可以有效减少术中输血和患者住院天数,并维持术中常温,促进术后凝血功能。

Objective To investigate the efficacy of fluid warming nursing in elderly patientsundergoing Da Vinci robotic-assisted laparoscopic radical cystectomy. Methods A total of 108 patients with bladder cancer scheduled to DaVinci robotic-assisted laparoscopic radical cystectomy were recruited and randomly divided into the control group(n=55)receiving a warming blanket(41℃)during intraoperative period and the warming group(n=53)in which all intraoperative fluids were administered via a fluid warmer(41℃). The surgical data,body temperature,coagulation function indexes and postoperative complications were compared between the two groups. Results Compared to the control group,the warming group had significantly less intraoperative transfusion(P=0.028)and shorter hospitalization days(P<0.05). During the entire intraoperative period(from 1 to 6 h),body temperature was significantly higher in the warming group than in the control group. There were significant differences in preoperative fibrinogen,white blood cell,total bilirubin,intraoperative lactose,and postoperative thrombin time(TT)and platelet between the control and warming groups. Multivariate linear regression analysis demonstrated that TT was the only significant factor,suggesting that the warming group had lower TT level than the control group.Conclusion Fluid warming nursing can effectively reduce transfusion requirement and hospitalization days,maintain intraoperative normothermia and promote postoperative coagulation function.