电阻加温垫与充气加温毯预防胸腔镜手术患者低体温效果比较
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摘要
目的探讨两种加温方式预防胸腔镜手术患者术中低体温的效果。方法将70例胸腔镜手术患者随机分为两组,电阻组(34例)术中采用电阻式碳纤维加温垫加温,充气组(36例)采用充气式加温毯覆盖加温。结果两组各测量时间点患者平均体温均>36℃,在麻醉插管、手术开始时、手术开始30 min时电阻组患者体温高于充气组(均P<0.01);手术开始1 h后至手术结束,两组体温差异无统计学意义(均P>0.05)。结论两种加温方式均能有效预防胸腔镜手术患者术中低体温,其中电阻式碳纤维加温垫维持患者体温更平稳。
Objective To compare the effect of two warming methods on prevention of hypothermia during video-assisted thoracic surgery.Methods A total of 70 patients undergoing video-assisted thoracic surgery were recruited and randomly allocated to receive either forced-air warming(n = 36) or resistive heating(n = 34).Results The mean patient core temperatures were higher than 36℃ during the surgery in both groups.Core temperatures were significantly higher in the resistive heating group compared with the forced-air warming group after intubation,at the start of surgery and at 30 min during the surgery(P<0.01 for all),but there were no significant differences between the two groups at 60 min during the surgery until the end of surgery(P > 0.05 for all).Conclusion Both resistive heating and forced-air warming are effective in preventing intraoperative hypothermia during video-assisted thoracic surgery,and the carbon-polymer resistive heating mattresses offer more stable temperatures.
Objective To compare the effect of two warming methods on prevention of hypothermia during video-assisted thoracic surgery.Methods A total of 70 patients undergoing video-assisted thoracic surgery were recruited and randomly allocated to receive either forced-air warming(n = 36) or resistive heating(n = 34).Results The mean patient core temperatures were higher than 36℃ during the surgery in both groups.Core temperatures were significantly higher in the resistive heating group compared with the forced-air warming group after intubation,at the start of surgery and at 30 min during the surgery(P<0.01 for all),but there were no significant differences between the two groups at 60 min during the surgery until the end of surgery(P > 0.05 for all).Conclusion Both resistive heating and forced-air warming are effective in preventing intraoperative hypothermia during video-assisted thoracic surgery,and the carbon-polymer resistive heating mattresses offer more stable temperatures.
引文
[1]Kurz A.Physiology of thermoregulation[J].Best Pract Res Clin Anaesthesiol,2008,22(4):627-644.
[2]李胜云,赵丽丽,李正伟.术前预保温对胃癌根治术患者术中体温变化的影响[J].护理学杂志,2013,28(6):44-46.
[3]Galv2o C M,Liang Y,Clark A M.Effectiveness of cutaneous warming systems on temperature control:meta-analysis[J].J Adv Nurs,2010,66(6):1196-1206.
[4]Reynolds L,Beckmann J,Kurz A,et al.Perioperative complications of hypothermia[J].Best Pract Res Clin Anaesthesiol,2008,22(4):645-657.
[5]李燕,佘渝,张乃萍.围术期低体温护理的研究进展[J].护理学杂志,2004,19(24):66-68.
[6]Scott E M,Leaper D J,Clark M,et al.Effects of warming therapy on pressure ulcers-a randomized trial[J].AORNJ,2001,73(5):921-927,929-933,936-938.
[7]Hooper V D,Chard R,Clifford T,et al.ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia[J].J Perianesth Nurs,2010,25(6):346-365.
[8]Sessler D I.Temperature monitoring:the consequences and prevention of mild perioperative hypothermia[J].South Afr J Anaesth Analg,2014,20(1):25-31.
[9]颜虹,徐勇勇,赵耐青,等.医学统计学[M].3版.北京:人民卫生出版社,2016:254-255.
[10]Ruetzler K,Kovaci B,Sessler D I,et al.Forced-air and a novel patient-warming system(vitalheat vh2)comparably maintain normothermia during open abdominal surgery[J].Anesth Analg,2011,112(3):608-614.
[11]Negishi C,Hasegawa K,Mukai S,et al.Resistive-hea-ting and forced-air warming are comparably effective[J].Anesth Analg,2003,96(6):1683-1687.
[12]NICE Guideline Development Group.Hypothermia:prevention and management in adults having surgery[EB/OL].(2018-04-10)[2018-07-04].www.nice.org.uk/nicemedia/pdf/CG65NICEGuidance.pdf.
[13]吴雪蕾.热空气加温仪临床应用研究进展[J].护理研究,2012,26(17):1548-1549.
[14]金歌,刘延锦,王静平,等.不同保温温度对腹部手术患儿体温变化的影响[J].中华护理杂志,2016,51(5):583-586.
[15]Cywinski J B,Xu M,Sessler D I.Predictors of prolonged postoperative endotracheal intubation in patients undergoing thoracotomy for lung resection[J].J Cardiothorac Vasc Anesth,2009,23(6):766-769.
[16]Zocchi L.Physiology and pathophysiology of pleural fluid turnover[J].Eur Respir J,2002,20(6):1545-1558.
[17]Baker N,King D,Smith E G.Infection control hazards of intraoperative forced air warming[J].J Hosp Infect,2002,51(2):153-154.(本文编辑吴红艳)
[2]李胜云,赵丽丽,李正伟.术前预保温对胃癌根治术患者术中体温变化的影响[J].护理学杂志,2013,28(6):44-46.
[3]Galv2o C M,Liang Y,Clark A M.Effectiveness of cutaneous warming systems on temperature control:meta-analysis[J].J Adv Nurs,2010,66(6):1196-1206.
[4]Reynolds L,Beckmann J,Kurz A,et al.Perioperative complications of hypothermia[J].Best Pract Res Clin Anaesthesiol,2008,22(4):645-657.
[5]李燕,佘渝,张乃萍.围术期低体温护理的研究进展[J].护理学杂志,2004,19(24):66-68.
[6]Scott E M,Leaper D J,Clark M,et al.Effects of warming therapy on pressure ulcers-a randomized trial[J].AORNJ,2001,73(5):921-927,929-933,936-938.
[7]Hooper V D,Chard R,Clifford T,et al.ASPAN's evidence-based clinical practice guideline for the promotion of perioperative normothermia[J].J Perianesth Nurs,2010,25(6):346-365.
[8]Sessler D I.Temperature monitoring:the consequences and prevention of mild perioperative hypothermia[J].South Afr J Anaesth Analg,2014,20(1):25-31.
[9]颜虹,徐勇勇,赵耐青,等.医学统计学[M].3版.北京:人民卫生出版社,2016:254-255.
[10]Ruetzler K,Kovaci B,Sessler D I,et al.Forced-air and a novel patient-warming system(vitalheat vh2)comparably maintain normothermia during open abdominal surgery[J].Anesth Analg,2011,112(3):608-614.
[11]Negishi C,Hasegawa K,Mukai S,et al.Resistive-hea-ting and forced-air warming are comparably effective[J].Anesth Analg,2003,96(6):1683-1687.
[12]NICE Guideline Development Group.Hypothermia:prevention and management in adults having surgery[EB/OL].(2018-04-10)[2018-07-04].www.nice.org.uk/nicemedia/pdf/CG65NICEGuidance.pdf.
[13]吴雪蕾.热空气加温仪临床应用研究进展[J].护理研究,2012,26(17):1548-1549.
[14]金歌,刘延锦,王静平,等.不同保温温度对腹部手术患儿体温变化的影响[J].中华护理杂志,2016,51(5):583-586.
[15]Cywinski J B,Xu M,Sessler D I.Predictors of prolonged postoperative endotracheal intubation in patients undergoing thoracotomy for lung resection[J].J Cardiothorac Vasc Anesth,2009,23(6):766-769.
[16]Zocchi L.Physiology and pathophysiology of pleural fluid turnover[J].Eur Respir J,2002,20(6):1545-1558.
[17]Baker N,King D,Smith E G.Infection control hazards of intraoperative forced air warming[J].J Hosp Infect,2002,51(2):153-154.(本文编辑吴红艳)