加温输血对全身麻醉骨科手术患者术中中心体温的影响

目的探讨加温输血对全身麻醉骨科手术患者术中中心体温的影响。方法 将60例行全身麻醉手术且需术中输血的骨科患者按随机数字法分为干预组和对照组,两组各30人。干预组患者输血前采用便携式输液加温器将库存血加温直至37℃;对照组患者输血前将库存血放置在常温下15-20 min。采用肛温探头检测患者麻醉前和麻醉后30、60、90、120 min的肛温,并观测患者麻醉清醒后到离开苏醒室这段时间内的寒颤发生情况。结果干预组有2名患者、对照组有1名患者由于麻醉方式改变而退出研究。随着手术时间的推移,两组患者的肛温均呈下降趋势,差异有统计学意义（P〈0.05）;干预组患者的肛温下降的程度较小,与对照组比较差异有统计学意义（P〈0.05）。干预组和对照组患者寒颤发生率分别为32.14%和86.21%,差异有统计学意义（χ^2=17.809,P〈0.05）。结论加温输血可以有效避免体温的大幅度下降,可降低全身麻醉骨科手术患者寒颤的发生率,能提高患者的舒适度。

Effects of Warming Blood Transfusion on Core Temperature of Orthopaedic Surgery Patients under General Anesthesia during the Operation

Objective To explore the effect of warming blood transfusion on the core temperature and shivering of orthopaedic surgery patients under general anesthesia.Methods Sixty orthopaedic surgery patients under general anesthesia who required intraoperative blood transfusion were equally divided into a interventional group and a control group randomly.For the patients in the interventional group,the transfused blood was warmed up to 37 ℃ using portable fluid warmer.For the patients in the control group,the transfused blood was conserved at room temperature for 15-20min.The rectal temperatures were measured before the anesthesia and at 30,60,90,120 min after anesthesia using rectal temperature probe.The shivering of the patients was observed between recovery and leaving the recover room.Results Two patients in the interventional group and one in the control group were excluded from the study after randomization because of the change of anesthesia.The rectal temperature of the both groups were decreased with significant differences（P〈0.05）.Comparing to the interventional group,the rectal temperature of the control group was significantly decreased（P〈0.05）.The prevalences of shivering in the interventional group and the control group were 32.14% and 86.21% respectively with significant difference（χ^2=17.809,P〈0.05）.Conculsion Warming blood transfusion can avoid a significant decline of temperature,reduce the incidence of shivering and improve the comfort in orthopedic surgery patients under general anesthesia.