术中体温干预对非小细胞肺癌患者生命体征及术后恢复的影响

Effect of intraoperative temperature intervention on vital signs and postoperative recovery of non-small cell lung cancer patients

目的探讨术中体温干预对非小细胞肺癌(NSCLC)患者生命体征及术后恢复的影响。方法依据术中干预方式的不同将106例NSCLC患者分为常规组(n=51)和控温组(n=55),常规组患者给予常规术中干预,控温组患者给予术中体温干预。比较两组患者生命体征指标、术后恢复指标、应激反应指标[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、皮质醇(Cor)、促肾上腺皮质激素(ACTH)、肾上腺素]、肺功能指标[用力肺活量(FVC)、呼气流量峰值(PEF)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]及术后并发症发生情况。结果手术10 min(T1),控温组患者呼吸频率低于常规组,脉搏血氧饱和度(SpO2)、体温均高于常规组,差异均有统计学意义(P﹤0.05);手术30 min(T2)~麻醉苏醒5 min(T5),控温组患者收缩压、舒张压、心率、呼吸频率均低于常规组,SpO2、体温均高于常规组,差异均有统计学意义(P﹤0.05)。控温组患者术后下床活动时间、首次排气时间、首次排便时间、住院时间均明显短于常规组,差异均有统计学意义(P﹤0.01)。术后24 h,控温组患者hs-CRP、TNF-α、IL-6、Cor、ACTH、肾上腺素水平均低于常规组,差异均有统计学意义(P﹤0.05)。出院前,控温组患者FVC、PEF以及EORTC QLQ-C30评分均高于常规组,并发症总发生率低于常规组,差异均有统计学意义(P﹤0.05)。结论术中体温干预能够更好地维持NSCLC手术患者生命体征的平稳,减轻术后应激反应程度和并发症发生风险,促进患者的术后恢复,提高生活质量。

Objective To explore the effect of intraoperative temperature intervention on vital signs and postoperative recovery of non-small cell lung cancer(NSCLC)patients.Method According to different intraoperative intervention methods,106 NSCLC patients were divided into conventional group(n=51)and temperature control group(n=55),patients in the conventional group received routine intraoperative intervention,while patients in the temperature control group received intraoperative temperature intervention.The vital signs,postoperative recovery indicators,stress response indicators[high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),cortisol(Cor),adrenocorticotropic hormone(ACTH),epinephrine],lung function indicators[forced vital capacity(FVC),peak expiratory flow(PEF)],quality of life[European Organization for Research and Treatment of Cancer quality of life questionnaire core 30(EORTC QLQ-C30)],and incidence of postoperative complications were compared between the two groups.Result After 10 min of surgery(T1),the respiratory rate in the temperature control group was lower than that in the control group,while pulse oxygen saturation(SpO2)and body temperature were higher than those in the control group,and the differences were statistically significant(P<0.05).From 30 min after surgery(T2)to 5 min after anesthesia resuscitation(T5),the systolic blood pressure,diastolic blood pressure,heart rate,and respiratory rate in the temperature control group were lower than those in the control group,while the SpO2 and body temperature were higher than those in the control group,and the differences were statistically significant(P<0.05).The postoperative ambulation time,first exhaust time,first defecation time,and hospitalization time in the temperature control group were significantly shorter than those in the control group,and the differences were statistically significant(P<0.01).At 24 hours after surgery,the levels of hs-CRP,TNF-α,IL-6,Cor,ACTH,epinephrine in the temperature control group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before discharge,the FVC,PEF,and EORTC QLQ-C30 scores in the temperature control group were higher than those in the control group,and the total incidence of complications was lower than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Intraoperative temperature intervention can better maintain the stable vital signs of NSCLC surgical patients,reduce the degree of postoperative stress response and the risk of complications,promote postoperative recovery,and improve the quality of life of patients.