【摘要】 目的探讨麻醉诱导期不同预保温措施对胃肠开腹手术老年患者术中体温的影响。方法 2017年1月至2019年8月选择在本院住院择期行全身麻醉胃肠开腹手术患者60例,按照手术先后次序编号,采用随机数字表法,将60例患者分为对照组和观察组,每组各30例。观察组患者麻醉诱导期使用充气保温毯进行预保温20min;对照组患者麻醉诱导期采用普通盖被覆盖保温20min,两组术中均采用充气式暖风机持续保温。测量并记录两组患者麻醉诱导开始及手术开始后30min、60min、90min和手术结束时的体温及观察患者术中低体温发生情况。结果不同时间点两组患者体温值的组内效应检验,F=15.915,P<0.001;组间效应检验F=510.253,P<0.001;组间和组内交互效应检验,F=4.588,P=0.013。对照组各时间点的体温值比较,差异有统计学意义(F=71.380,P<0.001),手术结束时的体温值较醉诱导开始及手术开始后30min、60min、90min的体温值比较,差异有统计学意义(t值分别为-81.004,-61.949,-50.053,-44.058,均P<0.001)。观察组各时间点的体温值比较,差异无统计学意义(F=0.586,P=0.673)。观察组患者术中体温变化更加稳定。观察组术中低体温发生率13.33%低于对照组36.67%(χ~2=4.356,P=0.037)。结论胃肠开腹手术老年患者麻醉诱导期应用充气保温毯预保温,有助于保持患者围术期体温相对稳定,降低低体温发生率。更多还原

【Abstract】 Objective To investigate the effect of different pre insulation measures during anesthesia induction period on the intraoperative temperature of elderly patients undergoing gastrointestinal surgery. Methods From January 2017 to October 2018, sixty patients who were hospitalized in Huainan Chaoyang Hospital were selected for general anesthesia gastroenterotomy. According to the sequence of operation, 60 patients were numbered and divided into control group and observation group with 30 cases in each group.During anesthesia induction, the patients in the observation group were pre insulated for 20 minutes with inflatable blanket. The patients in the control group were covered with ordinary cover for 20 minutes, and the patients of both groups were continuously insulated with inflatable heater during operation. The temperature changes of the two groups were observed and recorded. Results Intra-group effect test of body temperature of the two groups at different time points showed that F=15.915, P<0.001. Intergroup effect test F=510.253, P<0.001. The intergroup and intra-group interaction effect test showed that F =4.588, P =0.013. The differences between the two groups were statistically significant(all P<0.001) in the body temperature at each time point of the control group(F =71.380, P <0.001). Therewas no statistically significant difference(F =0.586, P =0.673) in the body temperature of the observation group at each time point, and the change of body temperature in the observation group was more stable than that in the control group. The incidence of intraoperative hypothermia was 13.33%(4/30) in the observation group and 36.67%(11/30) in the control group, which were lower than those in the control group(36.67% and 30.00%, respectively), with a statistically significant difference( χ~2=4.356, P=0.037). Conclusion In the anesthesia induction period of the old patients undergoing gastroenterostomy surgery, the application of air insulation blanket is helpful to keep the patient’s intraoperative body temperature relatively stable and reduce the incidence of intraoperative hypothermia.更多还原