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充气保温毯联合肢体包裹聚乙烯袋在胃肠手术中的应用

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目的 探讨全麻胃肠手术患者联合应用充气保温毯与肢体包裹聚乙烯袋保温方法的临床价值.方法 采用回顾性研究法,选择2022年10月—2023年9月期间南方医科大学第七附属医院收治的90例全麻胃肠手术患者,根据术中使用的保温方法将其分为对照组(常规保温干预方法,n=45)、观察组(充气式恒温保温毯+肢体聚乙烯袋包裹方法,n=45).比较两组苏醒时间、停药时脑电双频指数(Bispeetral Index,BIS)值、生命体征、肾上腺素(Adrenaline,AD)与去甲肾上腺素(Norepinephrine,NE)检测结果、术中体温与不良事件(低体温、寒战、并发症)发生情况.结果 T3时刻,观察组体温高于对照组(P<0.05).经重复测度检验,两组不同时间点、组间体温差异有统计学差异(P<0.05),且组别与时间有交互作用(P<0.05).两组停药时BIS值比较,差异无统计学意义(P>0.05).观察组苏醒时间短于对照组(P<0.05).手术前,两组AD、NE指标比较,差异无统计学意义(P>0.05).术后60min,观察组AD、NE指标水平低于对照组(P<0.05).观察组术中低体温及寒战的总发生率低于对照组(P<0.05).两组术后并发症总发生率比较,差异无统计学意义(P>0.05).结论 在全麻胃肠手术患者中,上半身采用充气式恒温保温毯进行加温,并对四肢进行聚乙烯袋包裹,具有较好的保温效果,有助于维持术中体温的恒定,减少低体温、寒战的发生,并可减轻手术相关应激反应.
Inflatable thermal blankets combined with limb-wrapped polyethylene bags in gastrointestinal surgery
Objective To investigate the clinical value of the combined application of an inflatable thermal blanket and limb-wrapped polythene bag insulation method in patients undergoing gastrointestinal surgery under general anaesthesia..Methods Using the retrospective study method,90 cases of general anaesthesia gastrointestinal surgery patients admitted to the hospital during the period from October 2022 to September 2023 were selected and divided into the control group(conventional thermal insulation intervention method,n=45)and the observation group(inflatable thermostatic thermal insulation blanket+limb polyethylene bag wrapping method,n=43)according to the intraoperative thermal insulation method used,the two groups were compared in terms of time to awakening,bispeetral index(BIS)values at the time of drug withdrawal,vital signs,adrenaline(AD)and norepinephrine(NE)test results,intraoperative temperature and the occurrence of adverse events(hypothermia,chills,complications).Results The incidence of hypothermia in the observation group was 2.22%,which was lower than that of 11.11%in the control group.There were no cases of chills in the observation group,and the incidence of chills in the control group was 8.89%,and the total incidence of hypothermia in the observation group was lower than that of the control group(χ²=7.200,P=0.007).Immediately at the end of surgery,the observation group had a higher body temperature than the control group(P<0.05),and the difference in body temperature between the two groups at different time points and between groups was statistically different(P<0.05),and there was an interaction between group and time(P<0.05).There was no statistically significant difference in BIS values between the two groups at the time of drug cessation(P>0.05).The awakening time of the observation group was shorter than that of the control group(P<0.05).The systolic blood pressure and heart rate at the immediate end of the operation was smaller than that of the control group(P<0.05).The levels of AD and NE indexes were lower than those of the control group at 60 min after the operation(P<0.05).The difference in the occurrence of complications between the two groups was not statistically significant(P>0.05).Conclusion In patients undergoing gastrointestinal surgery under general anaesthesia,the upper half of the body is warmed with inflatable thermostatic insulation blankets and the extremities are wrapped in polyethylene bags,which have a better heat preservation effect,help to maintain constant intraoperative body temperature,reduce the incidence of hypothermia and chills,and reduce surgery-related stress reactions.

General anaesthesia surgeryInflatable thermostatic insulation blanketLimb wrappingGastrointestinal surgeryInsulation effect

于炳伟、伯广庆、邓素贞、余季辉

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南方医科大学第七附属医院,麻醉科,佛山 528244

南方医科大学第七附属医院,超声科,佛山 528244

南方医科大学第七附属医院,检验科,佛山 528244

全麻手术 充气式恒温保温毯 肢体包裹 胃肠手术 保温效果

2022年佛山市自筹经费类科技计划项目

2220001005465

2024

现代仪器与医疗
中国科学器材公司

现代仪器与医疗

影响因子:1.47
ISSN:2095-5200
年,卷(期):2024.30(5)