温热液体对人工关节置换患者血IL-6水平和低体温发生率的影响

Effect of Warm Fluid on Blood IL-6 Level and Incidence of Hypothermia in Patients with Artificial Joint Replacement

目的:探讨术中应用温热液体对人工关节置换术患者术中低体温发生率和血IL-6水平的影响。方法:选取2018年9月-2019年9月在洪湖市中医医院骨科择期行双侧人工关节置换术(双膝或双髋关节)且符合入选标准者108例。按照计算机产生的随机序列号将入选病例随机分为观察组与对照组,每组54例。观察组术中输入36.5 ℃~37.5 ℃的温热液体(包括库存血),并采用37 ℃的恒温冲洗液冲洗术区;对照组术中输入22 ℃~24 ℃液体及库存血,并用等温冲洗液冲洗术区。比较两组不同时间的低体温发生率和血IL-6水平。结果:术中2、3 h和术毕即刻,观察组患者的低体温发生率均低于对照组,差异有统计学意义(P<0.05)。观察组患者术毕即刻和术后各时间点的血IL-6水平均低于对照组,差异有统计学意义(P<0.05)。结论:通过将术中静脉及冲洗液体加温后给予人工关节置换术患者,可有效降低患者低体温的发生,维持血IL-6水平稳定。

Objective:To investigate the effect of intraoperative warm fluid on the incidence of hypothermia and blood IL-6 levels in patients undergoing artificial joint replacement.Method:From September 2018 to September 2019,108 patients who underwent bilateral artificial joint replacement (double knee or double hip) at the Orthopedics department of our hospital were selected.According to the random serial number generated by the computer,the selected cases were randomly divided into the observation group and the control group,54 cases in each group.In the observation group,36.5 ℃-37.5 ℃ warm liquid (including stock blood) was input during the operation,and the operation area was rinsed with a constant temperature 37 ℃ flushing liquid;in the control group,22 ℃-24 ℃ liquid and stock blood were input during the operation,and the operating area was rinsed with the isothermal rinse liquid.The incidence of hypothermia and blood IL-6 levels at different times were compared between the two groups.Result:The hypothermia rate of the observation group were lower than those of the control group at 2,3 h and immediately after the operation,the differences were statistically significant (P<0.05).The blood IL-6 levels in the observation group immediately after operation and at various time points after operation were lower than those in the control group,and the differences were statistically significant (P<0.05).Conclusion:The method of warming intraoperative veins and irrigation fluids to patients after artificial joint replacement can effectively reduce the occurrence of hypothermia and maintain stable blood IL-6 levels.