麻醉复苏期患者预防低体温保温措施的选择和对比-现代医学

麻醉复苏期患者预防低体温保温措施的选择和对比

单位：南京医科大学第一附属医院麻醉与围术医学科, 江苏南京 210009

分类号：R472.3

出版年·卷·期（页码）：2024·52·第一期（158-162）

摘要：

目的：探讨不同保温措施干预对麻醉复苏期患者术后低体温的预防效果。方法：选取2022年1月至12月在我院行全麻手术后进入麻醉复苏室(PACU)的402例患者作为研究对象，采用随机数字表法分为A、B、C三组。A组采用常规保温措施，B组采用充气式加温毯保温，C组采用改良充气加温被保温。收集患者一般资料，比较三组患者术中相关指标、在PACU复温情况以及麻醉后并发症发生率等指标。结果：三组患者复温时间、PACU停留时间、复温速度差异均有统计学意义(P＜0.05)，其中A组复温时间、PACU停留时间最长，复温速度最慢，而B组、C组之间各项指标无明显差异(P＞0.05)。三组间患者术后低体温、寒颤、躁动和苏醒延迟的发生率差异均有统计学意义(P＜0.05)，其中A组各指标的发生率最高，而B组、C组之间无明显差异(P＞0.05)。结论：与常规保温措施相比，充气式加温毯和改良充气加温被均能够达到快速复温和降低麻醉后并发症发生率的效果，其中改良充气加温被的经济成本更低，临床应用前景更广。

Objective: To investigate the preventive effect of different insulation measures on postoperative hypothermia in patients undergoing anesthesia resuscitation. Methods: 402 patients admitted to PACU after general anesthesia surgery in our hospital from January to December 2022 were selected as the study subjects and divided into three groups: A, B, and C by random number table. Conventional insulation measures were used in group A, inflatable warming blankets were used in group B for insulation, and modified inflatable heating quilt was used in group C. The general data of the patients were collected, and the intraoperative relevant indicators, rewarming in PACU, and the incidence of complications after anesthesia were compared among the three groups. Results: There were significant differences in rewarming time, PACU residence time, and rewarming rate among the three groups(P<0.05), with group A having the longest rewarming time and PACU residence time and the slowest rewarming rate, while there was no significant difference in various parameters between groups B and C(P>0.05). The incidence of postoperative hypothermia, chills, agitation and delayed recovery was statistically significant among the three groups(P<0.05), with the highest incidence of each index in group A, but there was no significant difference between groups B and C(P>0.05). Conclusion: Compared with the conventional insulation measures, both inflatable warming blankets and modified inflatable heating quilt can achieve rapid rewarming and reduce the incidence of complications after anesthesia, with modified inflatable heating quilt having a lower economic cost and a wider prospect for clinical application.

参考文献：

[1] 王一闵，杨华，范鹃，等.不同体温维持方式对预防围手术期低体温的效果观察[J].上海护理，2018，18(4)：42-44.
[2] 徐秀群，张佳佳，朱琴，等.体温保护在围术期患者中的应用现状及研究进展[J].东南大学学报(医学版)，2020，39(2)：229-232.
[3] RUETZLER K,KURZ A.Consequences of perioperative hypothermia[J].Handb Clin Neurol,2018,157:687-697.
[4] ALFONSI P,BEKKA S,AEGERTER P.Prevalence of hypothermia on admission to recovery room remains high despite a large use of forced-air warming devices:findings of a non-randomized observational multicenter and pragmatic study on perioperative hypothermia prevalence in France[J].PLoS One,2019,14(12):e0226038.
[5] 孙亮，高倩，王广，等.麻醉后恢复室期间全身麻醉患者发生低体温的影响因素[J].中华医学杂志，2021，101(1)：52-56.
[6] FUGANTI C C T,MARTINEZ E Z,GALVAO C M,et al.Effect of preheating on the maintenance of body temperature in surgical patients:a randomized clinical trial[J].Rev Lat Am Enfermagem,2018,26(10):e3057.
[7] MIYAZAKI R,HOKA S.What is the predictor of the intraoperative body temperature in abdominal surgery[J].J Anesth,2019,33(1):67-73.
[8] SANTOS R M D S F,BOIN I F S F,CARUY C A A,et al.Randomized clinical study comparing active heating methods for prevention of intraoperative hypothermia in gastroenterology[J].Rev Lat Am Enfermagem,2019,27:e3103.
[9] LEE Y,KIM K.Optimal application of forced air warming to prevent peri-operative hypothermia during abdominal surgery:a systematic review and meta-analysis[J].Int J Environ Res Public Health,2021,18(5):2517.
[10] LIU M,QI L.The related factors and countermeasures of hypothermia in patients during the anesthesia recovery period[J].Am J Transl Res,2021,13(4):3459-3465.
[11] LINK T.Guidelines in practice:hypothermia prevention[J].AORN J,2020,111(6):653-666.
[12] 宋欣华，马涛洪，梁宇俐.改良充气保温被在麻醉恢复室低体温病人复温中的应用效果观察[J].护理研究，2020，34(16)：2987-2989.
[13] 许立倩，曹艳冰，戴红霞，等.充气式保温毯用于麻醉复苏室全麻恢复期患者的效果观察[J].护理学杂志，2019，34(14)：31-32.
[14] 王凌玲.麻醉恢复期低体温危险因素和护理对策[J].中西医结合心血管病电子杂志，2020，8(23)：66-67.

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