术中上半身保温对侧卧位胸腔镜术患儿核心体温及生理指标的影响

Effects of Intraoperative Upper Body Insulation on Core Body Temperature and Physiological Indexes in Children Undergoing Thoracoscopic Surgery in Lateral Position

目的探讨术中上半身保温方案对侧卧位胸腔镜术患儿核心体温及生理指标的影响。方法选取进行侧卧位胸腔镜手术患儿105例,按随机数字表法分为对照组52例和试验组53例,对照组给予常规下半身保温方案,试验组以上半身加温方案,观察2组患儿侧卧位体位摆放后0 min(T0)、30 min(T1)、60 min(T2)、90 min(T3)和手术结束后(T4)5个时间点的膀胱温度和术中生理指标(出血量、心率、平均动脉压)及并发症发生率。结果侧卧位加温60min(T2)、90min(T3)后试验组膀胱温度高于对照组(P<0.05);术中试验组平均动脉压低于对照组(P<0.05),2组患儿出血量、心率比较差异无统计学意义(P>0.05);试验组低体温发生率低于对照组(1.88%比11.54%,P<0.05),试验组并发症总发生率低于对照组(3.77%比15.38%,P<0.05)。结论术中进行上半身保温能够提高侧卧位胸腔镜术患儿的核心温度,减少对平均动脉压的影响,有效预防低体温等不良事件。

Objective To investigate the effects of upper body thermal insulation program on core body temperature and physiological indexes in children undergoing thoracoscopic surgery in the lateral position.Methods A total of 105 children undergoing thoracoscopic surgery in the lateral decubitus position were randomly given either conventional lower body insulation program(control group,n=52)or upper body warming scheme(experimental group,n=53).Bladder temperature,intraoperative physiological indicators(blood loss,heart rate,mean arterial pressure)and complications were observed at 0(T0),30(T1),60(T2)and 90 minutes(T3)after patient placement in the lateral position and at the end of operation(T4).Results The bladder temperature in the experimental group was higher than that in the control group at T2 and T3(P<0.05).The intraoperative mean arterial pressure in the experimental group was lower than that in the control group(P<0.05).In addition,the incidence of hypothermia and the total incidence of complications in the experimental group were lower than those in the control group(1.88%vs 11.54%and 3.77%vs 15.38%,respectively,P<0.05).Conclusion Intraoperative upper body thermal insulation can increase the core temperature,reduce the effect on mean arterial pressure,and effectively prevent hypothermia and other adverse events in children undergoing thoracoscopic surgery in the lateral decubitus position.