摘要
目的 探讨体温保护对高血压患者术中体温及血流动力学的影响.方法 60 例行髋关节置换手术且手术前有明确高血压病史的患者纳入本次研究,按随机数字表法分为D组(静脉输注液体时用液体加温器加温至 37℃,术中使用循环水暖加温毯加温至 37℃)和C组(常规手术室环境下进行手术),每组 30 例.比较两组患者各时间点[入室(T0)、麻醉诱导(T1)、插管(T2)、手术开始(T3)、手术开始后 0.5 h(T4)、手术开始后 1 h(T5)、手术结束(T6)、拔管(T7)、拔管后 5 min(T8)]的体温及血流动力学指标[收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)]水平,术后 24 h血压变异系数.结果 D组T4、T5、T6、T8 时的体温分别为(36.4±0.2)、(36.3±0.2)、(36.4±0.3)、(36.4±0.3)℃,高于C组的(36.2±0.2)、(36.1±0.2)、(36.1±0.1)、(36.2±0.2)℃,差异具有统计学意义(P<0.05);两组T0、T1、T2、T3、T7 时的体温比较,差异无统计学意义(P>0.05).D组T3、T4、T5、T6 时的SBP、DBP、MAP高于C组,T7 时的SBP、DBP、MAP小于C组,T8 时的DBP、MAP低于C组,差异具有统计学意义(P<0.05);两组T0、T1、T2 时的SBP、DBP、MAP及T8 时的SBP比较,差异无统计学意义(P>0.05).术后 24 h,D组的SBP、DBP、MAP变异系数分别为(4.7±0.4)%、(8.8±2.1)%、(6.1±0.9)%,均低于C组的(10.1±2.9)%、(14.0±3.3)%、(11.8±3.2)%,差异有统计学意义(P<0.05).结论 术中体温保护有助于高血压患者术中体温和血流动力学的稳定,患者术后血压波动更小.
Abstract
Objective To investigate the effect of intraoperative body temperature protection on body temperature and hemodynamics in patients with hypertension.Methods 60 who underwent hip replacement surgery and had a clear history of hypertension before surgery were included in this study.They were randomly divided into group D(intravenous fluid was heated to 37℃by liquid heater,and intraoperatively heated to 37℃by circulating water heating blanket)and group C(operation under conventional operating room setting)according to random numerical table,with 30 cases in each group.Comparison was made on body temperature and hemodynamics index[systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)]at different time points[entering the operating room(T0),anesthesia induction(T1),intubation(T2),start of surgery(T3),0.5 h after surgery(T4),1 h after surgery(T5),end of surgery(T6),extubation(T7),and 5 min after extubation(T8)],as well as coefficient of variation of blood pressure at 24 h after surgery between the two groups.Results At T4,T5,T6 and T8,the body temperature in group D were(36.4±0.2),(36.3±0.2),(36.4±0.3)and(36.4±0.3)℃,respectively,which were higher than those of(36.2±0.2),(36.1±0.2),(36.1±0.1)and(36.2±0.2)℃in group C,and the difference was statistically significant(P<0.05).There was no statistically significant difference in body temperature at T0,T1,T2,T3 and T7 between the two groups(P>0.05).In group D,SBP,DBP and MAP at T3,T4,T5 and T6 were higher than those in group C;SBP,DBP and MAP at T7 were smaller than those in group C;DBP and MAP at T8 were lower than those in group C;the difference was statistically significant(P<0.05).There was no statistically significant difference in SBP,DBP,MAP at T0,T1 and T2 and SBP at T8 between the two groups(P>0.05).At 24 h after surgery,the coefficient of variation of SBP,DBP and MAP in group D were(4.7±0.4)%,(8.8±2.1)%and(6.1±0.9)%,respectively,which were lower than those of(10.1±2.9)%,(14.0±3.3)%and(11.8±3.2)%in group C,and the difference was statistically significant(P<0.05).Conclusion Intraoperative body temperature protection is helpful for the stability of body temperature and hemodynamics in patients with hypertension,and the fluctuation of blood pressure after surgery is less.
NETL
NSTL
维普
万方数据