输液加温对腹腔镜宫颈癌或卵巢癌根治术患者围术期血乳酸和麻醉苏醒的影响

Effects of warming infusion on the blood lactate and anesthesia recovery in laparoscopic surgery during cervical cancer or ovarian cancer radical cure

目的:探究输液加温对腹腔镜宫颈癌或卵巢癌根治术患者围术期血乳酸和麻醉苏醒的影响。方法:选择ASAⅠ或Ⅱ级全麻下行腹腔镜宫颈癌或卵巢癌根治术患者60例,随机分为两组,每组30例,输液加温组(C组):利用输液加温仪使输液温度加温至40℃;对照组(D组):输入室温下放置(23~25℃)的液体。观察两组患者麻醉前(T0)、术中30 min(T1)、术中120 min(T2)、术毕(T3)和拔管后10 min(T4)的动脉血乳酸和体温,记录两组患者麻醉恢复期睁眼时间和拔管时间,并记录两组拔管后躁动、寒战、嗜睡的发生例数。结果:D组在T 3和T 4时刻的血乳酸水平显著高于C组和T 0(P<0.05);D组在T 4时刻的鼻咽温度显著低于T0、T1和C组(P<0.05);C组的睁眼时间、拔管时间和拔管不良反应发生率均显著低于D组(P<0.05)。结论:腹腔镜宫颈癌或卵巢癌根治术中输液加温能降低血乳酸水平和维持体温正常,缩短全麻患者清醒和拔管时间,降低苏醒期不良反应发生率和提高苏醒期舒适性。

Objective:To observe the influence of warming infusion on the blood lactate and anesthesia recovery in laparoscopic surgery during cervical cancer or ovarian cancer radical cure.Methods:Sixty patients of gynecologic laparoscopic surgery of cervical cancer or ovarian cancer radical cure were randomly divided into two groups:the warming infusion group(Group C)and the control group(Group D),30 cases in each group.Group C was with warning infusion with temperature to 40℃,while the control infusion with room temperature at 23-25℃.The blood lactate and temperature were recorded before anaesthesia(T 0),30 min(T 1)and 120 min(T 2)during surgery,at the end of the operation(T 3)and 10 min after tracheal extubation.The time of eye opening on call,extubation time and number of occurrences of manic,chills,lethargy were observed.Results:In control group,blood lactate at T 3 and T 4 were increased significantly than that of the T 0 and the study group(P<0.05).The nasopharynx temperature of the control group at T 4 were increased significantly than that of the T 0,T 1 and the study group(P<0.05).The time of eye opening on call,extubation time and the adverse reaction rate after extubation in control group increased significantly than that of the study group(P<0.05).Conclusions:In laparoscopic surgery during cervical cancer or ovarian cancer radical cure,the warming infusion can reduce the blood lactate,keep the temperature at the normal range,reduce waking and extubation hours,reduce the the adverse reaction rate after extubation and improve awake comfort.