主动保温与常规保温对食管癌根治术患者术中体温、应激反应和术后苏醒质量的影响

Effects of Active Heat Preservation and Conventional Heat Preservation on Intraoperative Body Temperature,Stress Response and Postoperative Awakening Quality of Patients Undergoing Radical Esophagectomy

目的:探讨主动保温与常规保温对食管癌根治术患者术中体温、应激反应和术后苏醒质量的影响。方法:纳入我院2018年7月~2020年8月期间接收的食管癌根治术患者100例,采用随机数字表法将患者分为对照组(50例,常规保温)和观察组(50例,主动保温)。对比两组患者术中体温、应激反应和术后苏醒质量,观察两组并发症的发生率。结果:与对照组比较,观察组术后苏醒时间、拔除气管导管时间、手术时间、麻醉苏醒室滞留时间、住院时间均较短(P<0.05)。对照组手术开始时(T2)~术毕(T6)时间点体温逐渐下降(P<0.05)。观察组T2~T6时间点体温较T1时间点未见明显变化(P>0.05)。观察组T2~T6时间点体温高于对照组(P<0.05)。两组术后3 d肾上腺素(E)、内皮素(ET)以及C反应蛋白(CRP)均较术前升高,但观察组低于对照组(P<0.05)。观察组的并发症总发生率明显低于对照组(P<0.05)。结论:食管癌根治术患者术中进行主动保温干预,可维持体温,减轻围术期应激反应,改善术后苏醒质量,同时还可降低并发症发生率。

Objective:To investigate the effects of active heat preservation and conventional heat preservation on intraoperative body temperature,stress response and postoperative awakening quality of patients undergoing radical esophagectomy.Methods:100patients who underwent radical esophagectomy in our hospital from July 2018 to August 2020 were included.The patients were randomly divided into control group(50 cases,conventional heat preservation)and observation group(50 cases,active heat preservation)by random number table method.The intraoperative body temperature,stress response and postoperative awakening quality of the two groups were compared,and the incidence of complications was observed.Results:Compared with the control group,the postoperative awakening time,tracheal tube removal time,operation time,retention time in anesthesia awakening room and hospitalization time in the observation group were shorter(P<0.05).The body temperature in the control group decreased gradually from the beginning of operation(T2)~the end of operation(T6)time points(P<0.05).The body temperature in the observation group at T2~T6 time points had no significant change compared with that at T1 time points(P>0.05).The body temperature in the observation group at T2~T6 time points was higher than that in the control group(P<0.05).3 d after operation,the epinephrine(E),endothelin(ET)and C-reactive protein in the two groups were higher than those before operation,but the observation group was lower than the control group(P<0.05).The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion:Active heat preservation intervention in patients undergoing radical esophagectomy can maintain body temperature,reduce perioperative stress response,improve the quality of postoperative awakening,and reduce the incidence of complications.