摘要 目的:观察术中低体温对患者麻醉恢复期的影响。方法:选择全麻开腹手术患者60 例,ASA Ⅰ～ Ⅱ级。按照随机表法随机分为两组,常规组30 例,行常规手术,术中肛温34. 2～35. 5 ℃;保暖组30 例,术中注意保暖,室内温度维持在28～30 ℃,使用电子液体加温仪输液及输血,冲洗液用水温浴箱加温至37 ℃,术中肛温35. 6～36. 5 ℃。观察两组术前、术中及术后血压、心率、肛温、拔管时间、清醒时间、尿量、引流量、寒颤及躁动的发生率。结果:与保温组相比,常规组患者血压升高,心率增快,清醒延迟,引流量增多,寒颤、躁动发生率高。结论:术中低体温使术后氧耗增加,术后潜在并发症的发生机会增多。术中应监测体温,输液液体及冲洗液应加温,注意保持手术间温度,以降低上述反应的发生率。
Nursing intervention and effects of hypothermia in postoperation to postanesthesia recovery periodPZHANG Shuyue , ZHU Junyu ,PENGYanzeng , et alPPChinese Journal of Nursing ,22003 , 38 (3) :176.Abstract Objective : To investigate the effects of hypothermia in operation on recovery from anesthesia. Methods : 60 patients undergoing ab2
dome operation were randomly divided into two groups. All patients were generally anesthetized. In the conventional group( n = 30) rectal tem2perature was 34. 2 ℃to 35. 5 ℃. In the warmed group ( n = 30) rectal temperature was maintained between 35. 6 ℃to 36. 5 ℃. BP , HR , rec2tal temperature , extubation time , awaking time , drainage volume , urinary volume , shiver and restless movement were recorded before , duringand post operation. Results : In conventional group , BP was higher , HR was faster , awaking time was longer , drainage volume was morethan those in warmed group. The incidence of shiver and restless movement were also markedly higher in conventional group. Conclusion :Postoperative hypothermia can increase general O2 consumption and the incidence of postanesthesia complications. The patients tempratureshould be monitored during operation. In order to decrease the complications , we should increase the temperature in the operation room and allthe fluid received by the patients.
Key words Hypothermia ; Intraoperavive care ; Anesthesia ,general ; Anesthesia recovery periodAuthor’s address Department of Anesthesiology ,The Second Hospital of Hebei Medical University , Shijiazhuang ,050000
术中低体温是手术常见的并发症,特别是长时间手术、大手术、老年人和小儿手术后尤易发生。术中低体温使术中与术后交感神经张力增高,外周血管收缩, 循环阻力增加, 而且血液黏滞度增高。[1]Jurkovich 等[2] 发现创伤后低体温与患者的存活率相关,低体温者比正常体温者病死率明显增加。近来人们越来越多地关注术中低体温对患者的危害。为了探讨术中低体温对患者麻醉恢复期生命体征及其他并发症的发生是否存在影响,以便采取合理措施避免低体温的发生,我们观察了术中非人为因素所致低体温患者围术期的临床指标,并与正常体温组进行对照,报告如下。
1 资料与方法
1. 1 研究对象与分组
1. 2 方法
1. 3 观察指标
1. 4 统计学处理
2 结 果
3 讨 论
低体温使组织器官代谢率降低,从而可对组织起保护作用;然而另一方面,低体温抑制免疫功能,导致凝血机制紊乱等,[3] 尤其是降低机体各系统功能,可使循环系统外周血管阻力增加,引起肺血管阻力增高,心动过速,血压下降,心脏传导阻滞等严重并发症。[1]许多因素可以引起手术患者的体温变化。
4 小 结
术后低温可增加患者心脏做功,增加氧耗,加重心脏负担,心脏储备能力严重受限的患者且易发生意外事件。术中低体温可导致术后渗血多,苏醒延迟,并增加全麻后并发症的发生率,而术中保温可大大减少低温的发生率。故在手术过程中,护理人员应重视保持患者的体温,采取提高室温、输入加温液体、进行体温监测等措施,以尽量减少低温的发生。
参 考 文 献
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