手术室多模式保温策略对腹腔镜胃癌根治术患者体温和术后恢复的影响

Effect of multimodal heat preservation strategy in operating room on body temperature and postoperative recovery in patients undergoing laparoscopic radical gastrectomy for gastric cancer

目的:探究手术室多模式保温策略对腹腔镜胃癌根治术患者体温和术后恢复的影响。方法:选取2019年3月至2022年4月首都医科大学附属北京友谊医院收治的112例行腹腔镜胃癌根治术患者为研究对象,按照随机数字表法分为对照组(n=56)与观察组(n=56)。对照组行常规围手术期保暖干预,观察组行手术室多模式保温干预。比较2组围手术期指标、体温及术后恢复情况。结果:观察组术中60 min(T_(2))、术中120 min(T_(3))、术中180 min(T_(4))、手术结束时(T_(5))的体温均明显高于对照组(均P<0.05)。观察组围手术期体温降低幅度及术中低体温发生率均明显低于对照组(均P<0.05)。与对照组相比,观察组麻醉苏醒时间、麻醉后监测治疗室(post-anesthesia care unit,PACU)停留时间均更短,苏醒期寒战、苏醒期躁动发生率均明显更低(均P<0.05)。观察组术后1 d时生理功能、认知恢复率及总体恢复优良率均明显高于对照组(均P<0.05)。结论:手术室多模式保温策略可明显减少腹腔镜胃癌根治术患者体温流失,降低围手术期低体温发生率,可促进术后恢复并提升整体恢复质量。

Objective:To explore the effect of multimodal heat preservation strategy in operating room on body temperature and postoperative recovery in patients undergoing laparoscopic radical gastrectomy.Methods:A total of 112 patients undergoing laparoscopic radical gastrectomy for gastric cancer admitted to Beijing Friendship Hospital,Capital Medical University from March 2019 to April 2022 were selected and randomly(random number table method)divided into a control group(n=56)and an observation group(n=56).The control group received routine perioperative thermal insulation intervention,and the observation group received multimodal heat preservation strategy in the operating room.The perioperative indicators,body temperature,and postoperative recovery were compared between the 2 groups.Results:The body temperature at 60 min(T_(2)),120 min(T_(3)),180 min(T_(4)),and at the end of operation(T_(5))in the observation group were significantly higher than those in the control group(all P<0.05).The rate of decrease in perioperative temperature and the incidence of hypothermia in the observation group were significantly lower than those in the control group(both P<0.05).Compared with the control group,the anesthesia recovery time and post-anesthesia care unit(PACU)stay time were shorter,and the incidence of shivering and emergence agitation was significantly lower in the observation group(all P<0.05).The physiological function,cognitive recovery rate,and overall recovery rate in the observation group were significantly higher than those in the control group(all P<0.05).Conclusion:The multimodal heat preservation strategy in the operation room can significantly reduce the temperature loss in patients undergoing laparoscopic radical gastrectomy,reduce the incidence of perioperative hypothermia,promote postoperative recovery,and improve the overall quality of recovery.