浅表大血管保温联合自发热暖贴在复杂创伤手术患者术中低体温的应用

目的探讨浅表大血管保温联合自发热暖贴在复杂创伤手术患者术中低体温的应用效果.方法选取2021年1月至2022年1月在浙江省人民医院手外修复与重建外科行复杂创伤手术患者118例.按随机数字表法分为3组,即常规充气式温毯仪加温组(N组)、浅表大血管保温组(Q组)、浅表大血管保温联合自发热暖贴加温组(Z组).比较三组患者术中低体温发生率、术中压力性损伤发生率、术中热损伤发生率、麻醉恢复室期间寒战发生率.结果N组和Q组低体温发生率比较差异无统计学意义(P>0.05),Z组与Q组、Z组与N组低体温发生率比较差异有统计学意义(P<0.05).三组患者术中压力性损伤发生率无统计学意义.N组热损伤发生率高于Q组和Z组,Z组寒战发生率低于Q组和N组,差异有统计学意义(P<0.05).结论在复杂创伤手术中采用浅表大血管保温联合自发热暖贴加温可以降低患者低体温发生率,同时降低患者热损伤和寒战的发生率.

Objective To explore the application effect of superficial large blood vessel insulation combined with self-heating warm paste in patients with complex trauma surgery.Methods From January 2021 to January 2022,118 patients who underwent complex trauma surgery in the Department of hand repair and reconstruction of Zhejiang Provincial People's hospital were selected.According to the random number table method,they were divided into three groups:conventional inflatable blanket heating group(N group),superficial large blood vessel insulation group(Q group)and superficial large blood vessel insulation combined with self-heating warm paste group(Z group).The incidence of intraoperative hypothermia,intraoperative pressure injury,intraoperative heat injury and shivering in anesthesia recovery room were compared among the three groups.ResultsThere was no significant difference in the incidence of hypothermia between group N and group Q(P>0.05),but there was significant difference in the incidence of hypothermia between group Z and group Q and between group Z and group N(P<0.05).The incidence of intraoperative pressure injury in the three groups was not statistically significant.The incidence of heat injury in group N was higher than that in group Q and group Z,and the incidence of shivering in group Z was lower than that in group Q and group N,with statistical significance(P<0.05).Conclusion The use of superficial large blood vessels combined with self-heating warm patch heating in complex trauma surgery can reduce the incidence of hypothermia,heat injury and shivering.