静脉输注加温液体与体外暖风加温对预防术中低体温效果的比较

Difference of warm liquid infusion and forced-air warming during operation in preventing hypothermia

关键词:  加温液体输注  体外暖风加温  预防术中低体温  恶心  呕吐  寒战

Key words:  warm liquid infusion  forced-air warming  hypothermia preventing  nausea  vomiting  shivering

摘要:

目的探讨静脉输注加温液体与体外暖风加温对预防术中低体温效果的比较。方法选择100例行全麻腹腔镜直肠癌根治术的患者作为研究对象，将100例患者随机分成观察组和对照组，每组50例。观察组行术中静脉输注加温液体来预防低体温；对照组行体外暖风加温来预防术中低体温，两组加温方式均在术中。比较两组患者的体温状况、术后并发症发生情况、寒战发生率以及寒战程度。结果两组患者经过不同方式加温以后，观察组的体温高于对照组，两组患者的中心体温测量结果差异有统计学意义（P<0.05）。观察组出现3例恶心、呕吐，1例呼吸抑制；对照组出现10例恶心、呕吐，3例呼吸抑制，两组术后并发症发生率有统计学差异（P<0.05）。观察组的寒战发生率为8%（4例）、对照组的寒战发生率为46%（23例），按照时间节点的不同，在麻醉苏醒后的10 min时，观察组寒战发生率更低（χ²=6.573，P<0.05），当麻醉苏醒后30 min时，两组的寒战率比较无统计学差异（χ²=3.481，P>0.05）；根据寒战程度比较，观察组寒战程度为1、2、3、4级的病例数分别为2、1、1、0例；对照组寒战程度为1、2、3、4级的病例数分别为9、7、5、2例，两组统计学差异明显（χ²=16.072，P<0.05）。结论静脉输注加温液体预防术中低体温效果显著，可以减少并发症发生率、降低寒战发生率并改善寒战程度，值得临床推广应用。

Abstract:

Objective To compare the effect of warm liquid infusion and forced-air warming during operation on preventing hypothermia. Methods One hundred patients undergoing laparoscopic radical resection of rectal cancer were divided into observation group (warm liquid infusion) and control group (forced-air warming) evenly and randomly. Body temperature, postoperative complications, shivering occurrence and levels were compared between the two groups. Results The body temperature of patients in observation group were higher than in control group (P<0.05). There were 3 and 10 cases of nausea and vomiting, 1 and 3 case of respiratory depression in observation group and control group, respectively (P<0.05). Compared with the control group, the shivering occurrence was fewer, especially at 10 min after awake (P<0.05), and shivering levels were lower in the observation group (P<0.05). Conclusion In preventing hypothermia during operation, warm liquid infusion would be better than forced-air warming.