加温加湿CO_(2)在预防人工气胸胸腔镜下食管癌切除手术患者术中低体温中的应用效果

Effect of warming and humidifying CO;on the prevention of intraoperative hypothermia in patients undergoing thoracoscopic resection of esophageal cancer with artificial pneumothorax

目的:观察加温加湿CO_(2)在人工气胸胸腔镜下食管癌切除手术中维持患者术中体温、预防患者术中低体温的效果。方法:选取人工气胸胸腔镜下食管癌切除手术患者69例作为研究对象,将注入加温加湿CO_(2)的35例设为试验组;将注入未加温加湿CO_(2)的34例设为对照组。观察两组患者不同时间点的核心体温、术中低体温发生率、寒战发生率及苏醒时间。结果:两组患者的年龄、身高、体重、性别、ASA分级、建立人工气胸时长、手术总时长、出入量的差异均无统计学意义(P>0.05)。两组患者在手术开始前和建立人工气胸后30 min的核心体温差异无统计学意义(P>0.05);而两组患者在建立人工气胸后60 min、撤除气胸时、撤除气胸后30 min及手术结束时的核心体温差异具有统计学意义(P<0.05);两组患者的核心体温均随手术时间的推进而逐步下降,但试验组的下降幅度低于对照组。试验组患者术后寒战发生率低于对照组,但差异无统计学意义(P>0.05);试验组患者术中低体温发生率低于对照组,苏醒时间短于对照组,且差异均有统计学意义(P<0.05)。结论:在胸腔镜下食管癌根治手术中运用加温加湿CO_(2)建立人工气胸有利于维持患者术中体温,减少术中体温的下降幅度,还可以降低术中低体温的发生率,缩短术后苏醒时间。

Objective To observe the effect of warming and humidifying CO_(2) on maintaining intraoperative body temperature and preventing intraoperative hypothermia in patients with artificial pneumothorax and thoracoscopic resection of esophageal cancer.Method A total of 69 patients undergoing thoracoscopic resection of esophageal cancer under artificial pneumothorax were selected as the research subjects,and 35 patients injected with warm and humidifying CO_(2) were set as the experimental group.34 cases injected with unheated and humidified CO_(2) were set as control group.The core body temperature,the incidence of intraoperative hypothermia,the incidence of chills and the time of awakening in 2 groups were observed at different time points.Results There were no significant differences in age,height,weight,gender,ASA classification,length of artificial pneumothorax establishment,total duration of operation,and amount of access between 2 groups(P>0.05).There was no significant difference in core body temperature between the two groups before surgery and 30 min after the establishment of artificial pneumothorax(P>0.05).There were significant differences in core body temperature between the two groups at 60min after the establishment of artificial pneumothorax,30min after the removal of pneumothorax,and at the end of surgery(P<0.05).The core body temperature in both groups decreased gradually with the advance of operation time,but the decrease rate in the experimental group was lower than that in the control group.The incidence of postoperative shivering in the experimental group was lower than that in the control group,but the difference was not statistically significant(P>0.05).The incidence of intraoperative hypothermia in the experimental group was lower than that in the control group,and the recovery time was shorter than that in the control group,and the differences were statistically significant(P<0.05).Conclusion The application of warming and humidifying CO_(2) to establish artificial pneumothorax in thoracoscopic radical resection of esophageal cancer is beneficial to maintain the patient′s intraoperative body temperature,reduce the decrease of intraoperative body temperature,reduce the incidence of intraoperative hypothermia,and shorten the postoperative recovery time.