Bair-Hugger升温系统间断热疗应用于低体重先天性心脏病患儿术中的效果

Intermittent Hyperthermia with a Bair Hugger Warming System:Intraoperative Effects in Children with Low Weight Congenital Heart Disease

目的探讨Bair-Hugger升温系统间断热疗应用于低体重先天性心脏病患儿术中的效果。方法将2019年1月-2021年4月60例深圳市儿童医院收治的低体重先天性心脏病患儿按照随机数字表法分为两组,对照组30例予以充气加温毯,研究组30例予以Bair-Hugger升温系统间断热疗。比较两组各时间指标、不同时刻体温情况、乳酸值、血小板活化因子(PAF)、血清神经元特异性烯醇化酶(NSE)以及压疮发生情况。结果两组主动脉阻断时间、体外循环时间、手术时间、清醒时间、术后呼吸机支持时间、ICU停留时间比较无统计学意义(P>0.05),研究组体外循环复温时间短于对照组(P<0.05)。研究组手术结束时直肠温、手术结束时鼻咽温、入ICU即刻直肠温、入室后6h直肠温均高于对照组(P<0.05)。研究组复温后60min、90min乳酸值低于对照组(P<0.05)。研究组体外循环停机前、手术结束时PAF和NSE水平低于对照组(P<0.05)。研究组压疮发生率(3.33%)低于对照组(23.33%)(P<0.05)。结论Bair-Hugger升温系统间断热疗应用于低体重先天性心脏病患儿术中可促进患儿体温快速回温,降低患儿乳酸、PAF和NSE含量,压疮风险较低。

Objective To investigate the effect of intermittent hyperthermia with a Bair Hugger warming system applied intraoperatively in children with low weight congenital heart disease.Methods Sixty children with low weight congenital heart disease admitted to our hospital between January 2019 and April 2021 were divided into two groups according to the random number table method,30 in the control group by an aerated warming blanket,and 30 in the study group by intermittent hyperthermia with a Bair Hugger warming system.The two groups were compared for indexes and body temperature situation at different moments,lactate value,platelet activating factor(PAF),serum neuron specific enolase(NSE),as well as the occurrence of pressure ulcers.Results There was no significant difference between the two groups regarding aortic occlusion time,cardiopulmonary bypass time,operation time,waking time,postoperative ventilator support time,or length of ICU stay(P>0.05),and the rewarming time of cardiopulmonary bypass in the study group was shorter than that in the control group(P<0.05).Rectal temperature at the end of surgery,nasopharyngeal temperature at the end of surgery,rectal temperature immediately after admission to the ICU,and rectal temperature 6h after admission were higher in the study group than in the control group(P<0.05).Lactate values at 60 min and 90 min after rewarming in the study group were lower than those in the control group(P<0.05).The levels of PAF and NSE before and at the end of cardiopulmonary bypass shutdown in the study group were lower than those in the control group(P<0.05).The incidence of pressure ulcers in the study group(3.33%)was lower than that in the control group(23.33%)(P<0.05).Conclusion Intermittent hyperthermia with a Bair Hugger warming system applied to children with low weight congenital heart disease intraoperatively promotes rapid rewarming of temperature and decreases lactate,PAF,and NSE levels in children,with a low risk of pressure ulcers.