术中保温对开腹手术患者术后感染的影响

Impact of intraoperative warming on postoperative infection in patients undergoing open surgery

目的探究术中保温对开腹手术患者术后感染的影响。方法选择2015年4月-2017年8月在淄博市第一医院接受开腹手术治疗的3719例患者作为研究对象,年龄16~73岁,平均(49.43±14.95)岁。采用随机数表法将患者分为对照组和研究组,其中对照组2210例,研究组1509例,对照组术中常规手术铺巾覆盖,研究组患者在对照组基础上采用充气保温毯保温。对两组患者一般资料、患者体温变化情况、凝血指标变化情况以及两组患者术后手术部位感染发生率进行相关统计分析。结果本研究中3719例患者共有149例发生感染,其中对照组感染率6.11%,研究组感染率0.93%;且对照组手术过程中体温下降明显,而研究组手术过程中体温保持恒定水平,对照组患者手术过程中PT、APTT、TT水平下降明显,而研究组相对保持恒定水平或轻微下降。结论术中采用充气保温毯保温可以使患者术中体温、凝血指标基本保持恒定,术后感染率明显降低,值得临床推广。

OBJECTIVE To explore the impact of intraoperative warming on postoperative infection in patients undergoing open surgery.METHODS A total of 3719 patients who received open surgery in Zibo First Hospital from Apr 2015 to Aug 2017 were recruited as the study objects,the patients were aged between 16 and 73 years old,with the mean age(49.43±14.95)years old.The patients were randomly divided into the control group with 2210 patients and the study group with 1509 patients.The control group was treated with routine surgical drape during the surgery,while the study group was given additional heat insulation by insulated insulation blanket.The baseline data,body temperature,blood coagulation indexes and incidence of postoperative surgical site infection were observed and statistically analyzed.RESULTS Of the 3719 patients,149 had infection;the incidence rate of infection was 6.11%in the control group,0.93%in the study group.The body temperature of the control group was remarkably declined during the surgery,while the study group maintained a constant body temperature during the surgery.The levels of PT,APTT and TT of the control group were remarkably declined during the surgery,while the levels of the above indexes of the study group remained constant or slightly declined.CONCLUSION The intraoperative use of thermal insulation blanket for heat preservation may keep the body temperature and blood coagulation indexes constant during the surgery,the incidence of postoperative infection is remarkably reduced,and it is worthy to be promoted in hospitals.