老年患者前列腺电切手术期间体温保护的临床观察

发布时间：2019-04-16 15:36

【摘要】：目的观察曲马多静注联合物理保温预防老年患者经尿道前列腺电切术(trans urethral resection prostate,TURP)围术期低体温发生的临床意义。方法收集本科2014年6月至2015年6月拟行TURP的老年患者75例,年龄60~70(64.58±2.24)岁。采用抽签的方法分为曲马多药物保护组、物理保温组和联合保护组,每组25例。入室心电监护,观察并记录肛温,3组患者均采用腰麻联合硬膜外麻醉。曲马多药物保护组患者给予常规干预,麻醉后静脉给予曲马多1.5 mg/kg稀释后缓慢静注,等渗冲洗液及静脉输液均为室温(22℃),围术期不作任何加温保护。物理保温组等渗冲洗液及静脉输注液体预先加温至38℃,手术床铺设38℃循环水毯,充气加温毯进行体表覆盖。联合保护组患者综合上述两种保护方法。记录3组患者术前(T1)、手术开始即刻(T2)、手术1 h(T3)、手术结束(T4)体温。同时评估患者术后寒战、心律失常发生情况和术后平均住院时间。结果 3组患者术前一般情况及术中输液量和冲洗液量比较差异无统计学意义(P0.05)。T3、T4时刻,联合保护组体温明显高于其余两组(P0.05)。单纯物理或者药物保护组患者随手术时间推移,体温呈逐渐下降趋势,T3、T4时刻与术前体温比较有明显差异(P0.05),而联合保护组患者围术期体温没有明显的波动。联合保护组围手术期的寒战、心律失常发生率低于其他两组,术后平均住院天数也明显低于其他两组(P0.05)。结论曲马多静注联合物理保温能更有效地避免老年患者TURP术中低体温的发生,并减少寒战、心律失常和尿路感染等并发症发生。
[Abstract]:Objective to observe the clinical significance of tramadol intravenous injection combined with physical insulation in the prevention of perioperative hypothermia in elderly patients undergoing transurethral resection of prostate (trans urethral resection prostate,TURP). Methods from June 2014 to June 2015, 75 elderly patients aged 60-70 (64.58 卤2.24) with TURP were collected. The patients were divided into tramadol drug protection group, physical insulation group and combined protection group with 25 cases in each group by drawing lots. The anal temperature was observed and recorded. All the patients in the three groups were treated with spinal anesthesia combined with epidural anesthesia. The patients in tramadol protection group were treated with conventional intervention. After anesthesia, tramadol was diluted by intravenous injection for 1.5 mg/kg and intravenous infusion was given at room temperature (22 鈩，

本文编号：2458892