智能温控充气加温器用于腹腔镜手术患者中对体温及应激反应影响的研究

An exploration on the application of intelligent temperature-controlled inflatable heater in patients undergoing laparoscopic surgery and the influence of that on body temperature and stress response

目的:探究智能温控充气加温器在腹部手术患者中的应用和对体温及应激反应的影响。方法:选取医院收治的110例腹腔镜手术患者,采取随机数表法将其分为观察组和对照组,每组55例。对照组结合患者的疾病类型并按照腹腔镜手术操作规范术中实施常规保温措施,观察组在对照组基础上术中增加智能温控充气加温器的应用,对比两组患者围术期进入手术室(T0)、麻醉后60min(T1)、苏醒即刻(T2)以及出麻醉复苏室(T3)的不同时间点的体温变化及血流动力学指标变化、苏醒时间、寒战发生率及分级,体温恢复慢及低体温患者比例以及术后24h内并发症发生率。结果:两组T1、T2与TO时间点相比体温有所降低,但在T3时间点开始升高,观察组与对照组相比T1、T2、T3时间点的体温较高,差异有统计学意义(t=14.128,t=24.764,t=33.264;P<0.05)。两组T1、T2、T3分别与T0时间点相比SBP、DBP、HR有所降低,差异无统计学意义。对照组与观察组T1、T2、T3的SBP、DBP、HR和SpO_(2)比较,差异有统计学意义(t_(SBP)=3.812,t=2.952,t=5.047;t_(DBP)=2.066,t=2.034,t=2.192;t_(HR)=2.832,t=5.881,t=8.209;t_(SpO_(2))=13.963,t=35.647,t=5.591;P<0.05),观察组术后苏醒时间短于对照组,差异有统计学意义(t=10.341,P<0.05);两组患者寒战发生率和低体温发生情况比较,差异有统计学意义(x^(2)=4.356,x^(2)=4.949;P<0.05),而两组体温恢复慢患者率和术后24h内并发症发生率相比差异无统计学意义。结论:智能温控充气加温器在腹腔镜手术患者中的应用可有效的预防低体温的发生,维持患者术中血流动力学指标更加稳定,缩短苏醒时间,降低应激反应,安全性较高。

Objective:To explore and analyze the application of intelligent temperature-controlled inflatable heater in patients who underwent abdominal surgery and the influence of that on body temperature and stress response.Methods:A total of 110 patients who underwent laparoscopic surgery were selected and they were divided into observation group and control group by random number table method,with 55 cases in each group.The control group implemented routine insulation measure through combined with the disease type of the patient and depended on the operating specifications of the laparoscopic surgery in the surgery,and the observation group added the application of intelligent temperature-controlled inflatable heater in the surgery on the basis of the control group.The changes of body temperature and hemodynamic indexes,the wake-up times,the incidence rates and the grades of shiver,the proportions of patients whose body temperature were slow recovery and the patients with hypothermia,and the incidence rates of complications within 24 h after surgery were compared between the two groups at different time points that included the time point that patients entered the operating room(T0)perioperative period,60 min after anesthesia(T1),the time of wake-up(T2)and the time away from post anesthesia recovery room(T3).Results:Compared with the T0 time point,the body temperature of the two groups decreased at T1 and T2,but began to increase at T3 time point.Compared with the control group,the body temperature of the observation group at T1,T2 and T3 time point were respectively higher,and the differences of them between two groups were statistically significant(t=14.128,t=24.764,t=33.264,P<0.05).Compared with the time point of T0,the SBP,DBP and HR of T1,T2 and T3 in the two groups were decreased respectively,while the differences of them were not statistically significant.The differences of the SBP(t=3.812,t=2.952,t=5.047,P<0.05),DBP(t=2.066,t=2.034,t=2.192,P<0.05),HR(t=2.832,t=5.881,t=8.209,P<0.05)and SpO_(2) levels(t=13.963,t=35.647,t=5.591,P<0.05)of T1,T2 and T3 between control group and observation group were respectively significant.The wake-up time after surgery of observation group was significantly shorter than that of control group,and the incidence rate of shiver of observation group was significantly lower than that of control group(t=10.341,x^(2)=4.356,P<0.05).The difference of the rate of hypothermia between two groups was statistical significance(x^(2)=4.949,P<0.05),while the difference of the rate of patients whose body temperature was slow recovery between two groups was no significant.There was no significant difference in the incidence rate of complication within 24h after surgery between two groups.Conclusion:The application of intelligent temperature-controlled inflatable heater in patients who undergo laparoscopic surgery can effectively prevent the occurrence of hypothermia,and maintain the better stability of intraoperative hemodynamic indexes of patients,and shorten the wake-up time,and reduce the stress reaction,which has higher safety.