Inditherm病员加温系统维持大面积烧伤伤员围手术期核心体温的效果评价

Evaluation of the Effect of Inditherm Patient Warming System on Maintaining Perioperative Core Body Temperature in Extensively Burned Patients

目的:探讨Inditherm病员加温系统在维持大面积烧伤伤员围手术期核心体温的效果。方法:将8.2昆山爆震伤中受伤的10例大面积烧伤患者设为加温组,其中男性3例,女性7例;平均年龄为37.6 ±6.87岁;烧伤面积均在95%以上合并气道损伤。挑选以往10例年龄、性别、烧伤面积以及病情均相同且未使用Inditherm病员加温系统治疗的大面积烧伤患者作为对照组,所有患者均利用测温导尿管(Ablexen美国)监测膀胱温度和生命体征监测,记录患者从手术开始以前、碘伏洗必泰消毒铺单后、手术开始后的30 min、60 min、90 min、120 min及手术结束时体温变化。患者任何一个温度【36.0℃以下为低体温,记录手术各时间点低体温的发生率。结果:手术过程中,对照组所有患者的核心体温均随手术时间的延长而降低,消毒时核心体温即明显下降,低体温的发生率为75%;手术开始30 min后低体温发生率即显著增高(P 【0.05),达到50%,并且低体温的发生率随着手术时间的延长而明显增高,60 min时为60%,90 min时为60%,120 min时达到85%。结论:我院在救治大面积烧伤伤员时,术中应使用加温系统维持患者的核心体温,预防低体温的出现,明显减少低体温的发生率,提高伤病员的救治成功率。

Objective: To investigate the effect of Inditherm patient warming system in maintaining perioper-ative core body temperature in extensively burned patients. Methods: 10 cases of large area burn caused by 8.2 Kunshan blast injury were divided into warming group, including 3 males and 7 females, which were divided into two groups;Mean age: 37.6 ±6.87 years;More than 95% of the patients with third degree burn were complicated with airway injury, and 10 patients with large area burn who were not treated with Inditherm patient warm-ing system and had the same age, sex, burn area and condition were selected as control group. The results of intraoperative temperature monitoring were compared with those of the control group. All patients were monitored by bladder temperature and vital signs using a thermometric catheter (Ablexen, USA). The temperature of patients was recorded before operation, after disinfection and sheeting, 30 min, 60 min, 90 min, 120 min after operation and at the end of operation. Hypothermia was defined as any temperature below 36.0?C. The incidence of hypothermia was recorded at each time point. Results: During the operation, the core body temperature of all the patients in the control group decreased with the prolongation of the operation time, and the core body temperature decreased significantly when disinfection was carried out. The incidence of hypo-thermia was 75%. The incidence of hypothermia increased significantly 30 minutes after the be-ginning of the operation (P <0.05), reaching 50%, and the incidence of hypothermia increased significantly with the extension of the operation time, reaching 60% at 60 minutes, 60% at 90 minutes and 85% at 120 minutes. Conclusion: In our hospital, heating system should be used to maintain the core body temperature, prevent the occurrence of hypothermia, reduce the incidence of hypothermia and improve the success rate of treatment.