保温对胃癌根治术患者苏醒及内稳态的影响

发布时间：2018-08-05 14:17

【摘要】：目的:探讨动力充气型升温仪联合输液加温对胃癌根治术患者苏醒及内稳态的影响。方法:选择全麻下行胃癌根治术患者80例,随机分为保温组和对照组,采用顺阿曲库铵、咪达唑仑、芬太尼、依托咪酯进行麻醉诱导,保温组采用动力充气型升温仪联合输液加温进行保温,对照组不进行保温。分别监测和记录两组患者在入室(T1)及麻醉诱导后60min(T2)、120min(T3)和术毕(T4)的鼻咽温度。观察两组患者苏醒及拔管时间和不良反应发生情况;不同时间点(T1、T2、T3、T4)采集桡动脉血测定血糖、血红蛋白、血乳酸含量及pH值。结果:(1)与T1比较,对照组在T2～T4时的鼻咽温均明显降低(P0.001);两组患者入室体温的比较无统计学差异(P0.05);对照组在T2～T4时的鼻咽温明显低于保温组同时间点(P0.001)。(2)与保温组比较,对照组患者自主呼吸恢复、睁眼及拔管时间均明显延长,术后寒颤、躁动和低血压发生率均明显升高(P0.05,P0.001)。(3)与T1比较,两组患者在T2～T4时的G1u和Lac含量均升高(P0.05),且对照组显著高于相应的保温组(P0.05);与T1比较,两组患者在T2～T4时的pH值和THb含量均降低(P0.05),且对照组显著低于相应的保温组(P0.05)。结论:采用动力充气型升温仪联合输液加温应用于胃癌根治术患者,能够有效地维持体温,减少低体温的发生;体温保护可以提高苏醒质量,维持内环境的相对稳定。
[Abstract]:Objective: to investigate the effect of dynamic inflatable warming instrument combined with infusion warming on the recovery and homeostasis of patients with gastric cancer after radical operation. Methods: 80 patients with gastric cancer undergoing radical gastrectomy under general anesthesia were randomly divided into heat preservation group and control group. The patients were anesthetized with cisatracurium, midazolam, fentanyl and etomidate. The heat preservation group was heated by dynamic inflatable warming instrument combined with infusion heating, while the control group was not. The nasopharyngeal temperature of 60min (T2) 120min (T3) and post-operation (T4) were monitored and recorded in both groups. The recovery time, extubation time and adverse reaction of the two groups were observed, and the blood glucose, hemoglobin, lactate content and pH value of radial artery blood were collected at different time points (T1T2T2T3T4). Results: (1) compared with T1, the nasopharyngeal temperature in the control group was significantly lower than that in the control group at T2~T4 (P0.001), and there was no significant difference in the body temperature between the two groups (P0.05), and the nasopharyngeal temperature in the control group was significantly lower than that in the thermal insulation group at the same time point (P0.001). (2) compared with the thermal insulation group (P0.001). (2). In the control group, the recovery of spontaneous respiration, the time of opening eyes and extubation were significantly prolonged, and the incidence of chills, restlessness and hypotension were significantly increased after operation (P0.05). (_ 3, P0.001). (_ 3) compared with T1, respectively. The levels of G1u and Lac in both groups increased at T2~T4 (P0.05), and the control group was significantly higher than the corresponding heat preservation group (P0.05); compared with T1, the pH value and THb content of the two groups in T2~T4 decreased (P0.05), and the control group was significantly lower than the corresponding thermal insulation group (P0.05). Conclusion: the application of dynamic inflatable warming instrument combined with infusion warming in patients undergoing radical gastrectomy can effectively maintain the body temperature and reduce the occurrence of hypothermia, and the temperature protection can improve the recovery quality and maintain the relative stability of the internal environment.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R614;R735.2

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