目的 探讨手术患者术中低体温的发生率、降低程度、发生术中低体温的重点人群及手术方式。
方法 采用便利抽样的方法将2013年7月-9月符合标准的手术患者170例作为研究对象。在患者全身麻醉后采用食道探头监测患者术中的体温,每半小时记录1次,了解患者麻醉后、手术开始后、打开腹腔后以及手术结束后的体温变化曲线。
结果 手术患者低体温率为52.9%(90/170)。开腹手术和神经外科手术低体温发生率较高,但各手术类型低体温发生率差异无统计学意义(P>0.05)。10例患者监测过程中发现体温过低,低至34.7℃,中途采用主动保温措施退出研究。手术患者术中体温变化可划分为4个阶段:下降期、快速下降期、平台期、上升期。
结论 手术患者术中未普遍采取主动加温措施,低体温发生率高。在手术结束前,随着手术时间的延长,体温逐渐降低。
Citation:
谭永琼, 陈忠兰, 廖安鹊. 手术患者术中体温变化规律的临床研究. West China Medical Journal, 2015, 30(8): 1544-1546. doi: 10.7507/1002-0179.20150444
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姜升立. 围手术期意外低体温的监测及预防[J]. 中华医院感染学杂志, 2013, 23(21):5378-5380.
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- 1. Putzu M, Casati A, Berti M, et al. Clinical complications, monitoring and management of perioperative mild hypothermia:anesthesiological features[J]. Acta Biomed, 2007, 78(3):163-169.
- 2. 潘春莉. 全麻手术后低体温的原因分析及护理[J]. 医学理论与实践, 2003, 16(8):974.
- 3. Kurz A. Thermal care in the perioperative period[J]. Best Pract Res Clin Anaesthesiol, 2008, 22(1):39-62.
- 4. Ng SF, Oo CS, Loh KH, et al. A comparative study of three warming interventions to determine the most effective in maintaining perioperative normothermia[J]. Anesth Analg, 2003, 96(1):171-176.
- 5. Xu HX, You ZJ, Zhang H, et al. Prevention of hypothermia by infusion of warm fluid during abdominal surgery[J]. J Perianesth Nurs, 2010, 25(6):366-370.
- 6. 马蔚蔚, 李春娥, 汪世高, 等. 围术期"温暖护理"对老年患者术后认知功能的影响[J]. 解放军护理杂志, 2011, 28(22):31-32, 35.
- 7. Yokoyama K, Suzuki M, Shimada Y, et al. Effect of administration of pre-warmed intravenous fluids on the frequency of hypothermia following spinal anesthesia for cesarean delivery[J]. J Clin Anesth, 2009, 21(4):242-248.
- 8. 党玉莲, 李文珍, 李秀婷, 等. 碘伏加温用于手术区域皮肤消毒[J]. 中华护理杂志, 2005, 40(4):254.
- 9. 姜升立. 围手术期意外低体温的监测及预防[J]. 中华医院感染学杂志, 2013, 23(21):5378-5380.