初始室温控制对卵巢癌开腹手术患者术中体温变化的影响

Effect of initial room temperature control on intra-operative temperature changes in patients with ovarian cancer undergoing open surgery

目的探讨初始室温控制对卵巢癌开腹手术患者术中体温变化的影响。方法将2020年3-5月在我院行开腹手术的卵巢癌患者40例设为A组,入室前、后30 min保持手术间温度恒定22℃;2020年6-8月在我院行开腹手术的卵巢癌患者40例设为B组,入室前、后30 min保持手术间温度恒定24℃;2020年9-11月在我院行开腹手术的卵巢癌患者40例设为C组,入室前、后30 min保持手术间温度恒定26℃,术中均给予综合保温措施。比较3组患者术中体温变化、低体温发生率、出血量、输液量、手术时长及术后复苏时长等指标。结果术前初始室温水平较高的组别整体上表现出体温变化趋势稳定,体温下降幅度小,开始麻醉时、麻醉后30 min、手术60 min、手术120 min和离开手术间时的体温存在显著差异(P<0.05或P<0.01);术前初始室温水平较高的组别术中发生低体温时间延迟(F=10.676,P<0.001)、低体温和术后寒战发生率低(χ2=6.664,P=0.036;χ2=7.516,P=0.023)、复苏时长短(F=4.242,P=0.019);3组患者出血量、输液量和手术时长比较,差异无统计学意义(均P>0.05)。结论通过维持较高水平的初始室温,能够有效延迟并减少卵巢癌患者术中低体温的发生,降低其术后复苏时长和寒战发生率。

Objective To investigate the effect of initial room temperature control on intra-operative temperature changes in patients with ovarian cancer undergoing open surgery.Methods 40 cases of ovarian cancer patients undergoing open surgery in our hospital from March to May 2020 were set as group A,and the operating room temperature was kept constant at 22℃for 30 minutes before and after entering the room;40 cases of ovarian cancer patients undergoing open surgery in our hospital from June to August 2020 were set as group B,and the operating room temperature was kept constant at 24℃for 30 minutes before and after entering the room;40 cases of ovarian cancer patients undergoing open surgery in our hospital from September to November 2020 were set as group C,the operating room temperature was kept constant at 26℃for 30 minutes before and after anesthesia induction.The changes of body temperature,incidence of hypothermia,blood loss,infusion volume,operation time and postoperative recovery time were compared among the three groups.Results The group with higher initial room temperature before operation showed a stable trend of temperature change and a small drop in body temperature,there were significant differences in body temperature at the beginning of anesthesia,30 minutes after anesthesia,60 minutes after operation and 120 minutes after operation and leaving the operating room(P<0.05 or P<0.01);hypothermia was delayed in patients with higher initial room temperature before operation(F=10.676,P<0.001).The incidence of hypothermia and postoperative shivering was low(χ2=6.664,P=0.036;χ2=7.516,P=0.023).Recovery time is short(F=4.242,P=0.019);there was no significant difference in blood loss,infusion volume and operation time among the three groups(all P>0.05).Conclusion Maintaining a high initial room temperature can effectively delay and reduce the occurrence of hypothermia in patients with ovarian cancer,reduce the postoperative recovery time and the incidence of shivering.