术前-术中-术后全程体温管理方案对全麻手术患者凝血功能、应激反应及术后康复的影响

Effect of whole process temperature management of pre-operative intra-operative postoperative on coagulation function,stress response,and postoperative recovery in patients undergoing general anesthesia surgery

目的探讨全麻手术患者实施术前-术中-术后全程体温管理方案对其凝血功能、应激反应及术后康复的影响。方法选取2022年1~12月南京医科大学第一附属医院全麻手术的病例110例,随机分为对照组和观察组,每组55例。对照组采用常规保温干预,观察组采用术前-术中-术后全程体温管理方案,比较2组的干预效果。结果观察组麻醉后60 min和术毕时的体温高于对照组(P<0.05)。2组术毕时的血清凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、凝血酶时间(TT)及纤维蛋白原(FIB)均高于术前,但观察组上升幅度低于对照组(P<0.05)。2组术毕时的血浆去甲肾上腺素(NE)、肾上腺素(E)水平均高于术前,但观察组上升幅度低于对照组(P<0.05)。观察组术后麻醉期恢复情况优于对照组(P<0.05)。观察组并发症发生率为9.09%,低于对照组的40.00%(P<0.05)。结论全麻手术患者实施术前-术中-术后全程体温管理方案,能有效减轻应激反应,减少凝血功能损伤,促进患者术后麻醉恢复,并能预防术中低体温和降低并发症的发生。

Objective To explore the effect of whole process temperature management of pre-operativ intra-operative postoperative on coagulation function,stress response,and postoperative recovery in patients undergoing general anesthesia surgery.Methods A total of 110 patients undergoing general anesthesia surgery admitted to the First Affiliated Hospital with Nanjing Medical University from January 2022 to December 2022 were included as the study subjects,and they were randomized 1:1 to routine insulation intervention(control group)or pre-operative intra-operative postoperative temperature management(observation group).The intervention effects of the two groups were compared.Results The body temperature of the observation group at minutes 60 of anesthesia and the end of surgery was significantly higher than that of the control group(P<0.05).The serum prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(FIB)at the end of both groups were higher than before surgery,but the increase in the observation group was lower than control group(P<0.05).The plasma levels of norepinephrine(NE)and epinephrine(E)at the end of surgery in both groups were significantly higher than before surgery,the increase was more common in the observation group compared to the control group(P<0.05).The anesthesia recovery of the observation group was superior to the control group(P<0.05).The incidence of complications in the observation group was significantly lower than that in the control group(9.09%vs 40.00%P<0.05).Conclusion The implementing of whole process temperature management of pre-operative intra-operative postoperative in patients undergoing general anesthesia surgery can effectively lower stress reactions,reduce coagulation function damage,promote postoperative anesthesia recovery,prevent intraoperative hypothermia and reduce the occurrence of complications.