两种核心体温监测方法对心脏直视手术体外循环时间及凝血功能的影响

目的 探讨两种核心体温监测方法对心脏直视手术体外循环时间及凝血功能的影响,为心脏直视手术核心体温监测提供参考.方法 将2016年6-12月该院的心脏直视手术患者140例分为对照组(n=70)和观察组(n=70),其中对照组监测膀胱温和鼻咽温,观察组监测直肠温和鼻咽温,记录手术中体外循环降温时间、阻断升主动脉时间、复温时间、体外循环总时间;两组患者均在术前1d及术毕抽血监测凝血功能,包括凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT).结果 对照组在降温时间、复温时间及体外循环总时间上均多于观察组,差异有统计学意义(P<0.01).术前两组患者的凝血功能指标(TT、PT、APTT)比较,差异无统计学意义(P>0.05);术毕两组患者的凝血功能指标(TT、PT、APTT)比较,差异有统计学意义(P<0.01),观察组凝血功能各指标优于对照组.结论 用直肠温监测体外循环下心脏直视手术患者的核心体温优于膀胱温,可以缩短体外循环时间,改善凝血功能.

Effects of two different core temperature monitoring methods on cardiopulmonary bypass time and coagulation function in open heart surgery

Objective To explore the effect of two different core temperature monitoring methods on cardiopulmonary bypass and coagulation function in open heart surgery to provide a reference for monitoring the core body temperature in open heart surgery. Methods One hundred and forty patients undergoing open heart surgery in this hospital from June to December 2016 were divided into the control group(n= 70) and observation group (n= 70). The control group monitored the temperature of nasopharynx and bladder. The observation group monitored the temperature of rectum and nasopharynx. The temperature falling time of cardiopul monary bypass, time of blocking ascending aorta,time of rewarming, total time of cardiopulmonary bypass were recorded during operation. The coagulation function was monitored on 1 d before surgery and at the end of surgery,including thrombolytic time (TT), prothrombin time (PT) and activated partial thromboplastin time (APTT). Results The temperature falling time,rewarming time, total time of cardiopulmonary bypass in the control group were more than those in the observation group, the difference was statistically significant(P<0.01);there was no statistically significant difference in coagulation function indicators(TT,PT,APTT) before operation between the two groups (P> 0.05). At the end of the operation, the coagulation function indicators (TT, PT, APTT) had statistically significant difference between the two groups (P<0.01). The coagulation function indicators in the observation group were better than those in the control group. Conclusion Using the rectal temperature for monitoring the core tempera ture in the patients undergoing open heart surgery under cardiopulmonary bypass is better than using bladder temperature, which can shorten the time of cardiopulmonary bypass and improves coagulation function.