术后轻度低体温患者组合保暖与充气式加温仪复温效果比较

目的 探讨组合保暖与充气式加温仪在术后轻度低体温患者中的应用效果。 方法 将90例术后轻度低体温患者随机分成两组各45例。观察组使用反光毯和棉被的组合保暖方式复温,对照组使用充气式加温仪复温。 结果 复温后两组的升温值差异未达非劣效边界。两组体感舒适度、寒战和心血管不良事件发生率无统计学差异（均P＞0.05）。 结论 组合保暖方式应用于轻度低体温患者的升温效率与充气式加温仪相当;体感舒适度和安全性与充气式加温仪也相似,适用于此类患者的术后复温。     

胸腔镜手术围术期综合保温干预对预防患者低体温及促进术后恢复的效果

目的 探讨胸腔镜手术围术期综合保温干预对预防患者低体温及促进术后恢复的效果.方法 回顾性分析2019-11—2020-10永城市人民医院手术室行胸腔镜手术的68例患者的临床资料.分为围术期常规保温干预组(对照组)和在常规保温干预的基础上联合综合保温干预组(观察组),每组34例.记录2组患者术中及麻醉复苏期间低体温、低氧...     

胸腔镜肺叶手术患者苏醒室低体温现况及影响因素

目的 探讨胸腔镜肺叶手术患者苏醒室低体温现况及影响因素,为开展针对性体温干预提供参考。方法 回顾性调查胸腔镜肺叶手术患者222例,将发生苏醒室低体温的患者作为病例组,以1∶1比例匹配苏醒室未发生低体温的患者(对照组),比较两组围手术期特征。结果 胸腔镜肺叶手术患者中93例(41.89%)发生苏醒室低体温;匹配成功两组各92例,经单因素与多因素分析,年龄、BMI、麻醉类型、麻醉时长、入室核心体温、手术准备时间是患者苏醒室低体温发生的主要影响因素(P<0.05,P<0.01);苏醒室低体温患者苏醒室停留时间、住院时间显著延长,并伴有尿量减少(均P<0.01)。结论 胸腔镜肺叶手术患者苏醒室低体温发生率偏高,护理人员应评估围手术期患者年龄、麻醉类型、麻醉时长、准备时间、BMI、入手术室核心体温,积极预防苏醒室低体温的发生,同时关注苏醒室低体温给患者造成的风险。     

充气式保温毯用于麻醉复苏室全麻恢复期患者的效果观察

目的评价充气式保温毯在麻醉复苏室预防全麻患者恢复期低体温及寒颤的效果。方法将80例择期全麻手术患者随机分为观察组和对照组各40例。对照组入麻醉恢复室后给予常规太空被保暖;观察组使用充气式保温毯保暖。评价两组患者体温变化及寒颤、苏醒延迟发生率。结果观察组低体温及苏醒延迟率显著低于对照组,入麻醉复苏室30 min、出室时体温显著高于对照组(P0.05,P0.01)。结论应用充气式保温毯能有效降低全麻恢复期患者低体温,促进患者麻醉后苏醒。     

可控充气式甲状腺楔形手术体位垫的制作与应用

目的探讨可控充气式甲状腺楔形体位垫的应用对降低甲状腺手术体位综合征的作用。方法将112例行甲状腺手术患者按时间分为对照组和观察组。对照组52例术中体位垫采用传统海绵肩垫加头圈;观察组60例采用自制可控充气式甲状腺楔形体位垫。比较两组患者术后头颈部痛、腰背部痛、呕吐发生率及手术医生满意度。结果观察组术后头颈部痛、腰背部痛及呕吐发生率显著低于对照组,手术医生满意度显著高于对照组(P0.05,P0.01)。结论甲状腺手术中使用可控充气式甲状腺楔形体位垫能够减少术后体位综合征的发生,提高手术医生满意度。     

腰硬联合阻滞麻醉患者术中水循环式保温毯的应用

目的探讨水循环式保温毯预防手术患者低体温的干预效果。方法将腰硬联合阻滞麻醉的住院手术患者100例随机分为两组。对照组(n=50)按常规护理,手术期间盖太空被。观察组(n=50)应用水循环式保温毯预防低体温,即患者除盖太空被外,卧于有水循环式保温毯覆盖的手术床上。结果观察组麻醉后、术中1h、术毕、出室前4个时间点的肛温高于同期对照组;观察组的术中低体温与寒战发生率、出院前手术部位感染发生率显著低于对照组;观察组舒适度评分显著高于对照组(P0.05,P0.01)。结论水循环式保温毯能有效预防手术患者低体温和寒战的发生。     

凡士林纱垫预防俯卧位手术患者头面部皮肤损伤效果观察

目的 探讨凡士林纱垫预防全麻俯卧位手术患者头面部皮肤损伤的效果。方法 将100例全麻俯卧位手术的患者随机分成观察组和对照组各50例，对照组在头面部受压处垫棉垫保护，观察组采用自制凡士林纱垫。结果 观察组预防皮肤损伤的效果显著优于对照组（P〈O．01）。结论 使用凡士林纱垫预防全麻俯卧位手术患者头面部皮肤损伤效果好，能减轻患者的痛苦。     

电视胸腔镜与传统开胸手术治疗外伤性血气胸的效果比较

目的 比较电视胸腔镜(VATS)和传统开胸手术治疗外伤性血气胸的临床效果.方法 血气胸患者41例随机分为实验组和对照组,对照组26例,采用传统开胸手术方法;实验组15例,采用VATS治疗,对两组患者一般临床资料、术中出血量、手术时间、术后胸管放置时间、术后引流量等进行比较.结果 41例患者均无手术死亡、二次开胸止血,术后均未呼吸机辅助呼吸.实验组术中出血量[(176.5 ±78.5) ml]明显少于对照组[(401.3±90.7)ml],手术时间[实验组(64.7-±21.3) min,对照组(129.4±30.3) min]、术后胸管放置时间[实验组(2.3±0.9)d,对照组(4.5±1.0)d]、住院时间[实验组(9.1±2.1)d,对照组(12.7±2.2)d]及术后并发症发生率等方面均少于对照组,两组比较差异有统计学意义(P＜0.05).结论 VATS治疗外伤性血气胸与传统开胸手术比较,诊断快速准确,安全可靠,并发症少.     

复合保温用于预防腹腔镜结直肠癌手术中低体温的效果观察

随着腹腔镜结直肠癌手术（laparoscopic colorectal—carcinoma surgery,LCS）的广泛开展,手术期间低体温对患者的影响也日益受到关注。腹腔镜结直肠癌手术患者术中低体温（〈36℃）相当常见,有报道轻度低温发生率为50％～70％。低体温可影响凝血功能、药物代谢、肾脏功能和心肌收缩力。     

泌尿外科腔镜手术围术期保温护理对预防术中低体温的效果

目的探讨泌尿外科腔镜手术围术期保温护理对预防术中低体温的效果。方法选取2017-02-2019-07间接受泌尿外科腔镜手术治疗的78例患者。将2017-02-2018-05间入院的38例患者作为常规组,围术期应用常规护理措施。将2018-06-2019-07间入院的40例患者作为保温组,围术期在常规护理基础上实施保温护理措施。回顾性分析患者的临床资料。结果常规组术中30 min及术后10 min的体温明显低于术前,差异有统计学意义(P<0.05)。保温组患者术中30 min及术后10 min的体温变化差异无统计学意义(P>0.05)。常规组术中低温、寒战等并发症发生率高于保温组,差异有统计学意义(P<0.05)。结论对行泌尿外科腔镜手术的患者加强围术期保温护理,可保持患者术中体温的稳定,减少术中低体温及相关并发症的发生风险,有利于提高治疗效果。     

Randomised trial comparing forced-air warming to the upper or lower body to prevent hypothermia during thoracoscopic surgery in the lateral decubitus position

Background

In the supine position, forced-air warming is more effective on the lower body than on the upper body to prevent intraoperative hypothermia. However, it is unknown in the lateral decubitus position. We thus compared forced-air warming on the upper and lower bodies in the lateral position.

Delayed forced air warming prevents hypothermia during abdominal aortic surgery

We have evaluated the efficacy of the delayed forced air warming during abdominal aortic surgery in 18 patients. Patients were allocated randomly to one of two groups: the control group (n = 9) received no intraoperative warming device; the Bair-Hugger group (n = 9) had active skin surface warming with an upper body cover. The device was activated when core temperature decreased to less than 36 degrees C. The reduction in core temperature was 0.6 degrees C during the first hour after induction and 0.4 degrees C during the second hour in both groups. In the control group, core temperature continued to decrease until the end of surgery, whereas in the Bair-Hugger group, the reduction in core temperature stopped after 1 h of warming, and then rewarming began. At the end of surgery, core temperature in the Bair- Hugger group was similar to core temperature before induction, and was higher than core temperature in the control group (P < 0.003).      

An evaluation of underbody forced-air and resistive heating during hypothermic, on-pump cardiac surgery

We conducted a randomised controlled trial to compare the efficacy of underbody forced-air warming (Arizant Healthcare Inc, Eden Prairie, MN, USA) with an underbody resistive heating mattress (Inditherm Patient Warming System, Rotherham, UK) and passive insulation in 129 patients having hypothermic cardiac surgery with cardiopulmonary bypass. Patients were separated from cardiopulmonary bypass at a core temperature of 35 °C and external warming continued until the end of surgery. Before cardiopulmonary bypass, the temperature-vs-time slopes were significantly greater in both active warming groups than in the passive insulation group (p < 0.001 for each). However, the slopes of forced-air and resistive warming did not differ (p = 0.55). After cardiopulmonary bypass, the rate of rewarming was significantly greater with forced-air than with resistive warming or passive insulation (p < 0.001 for each), while resistive warming did not differ from passive insulation (p = 0.14). However, absolute temperature differences among the groups were small.     

Prevention of hypothermia by cutaneous warming with new electric blankets during abdominal surgery

We have evaluated the efficacy of new electric warming blankets, which meet the requirements of the international standard for perioperative electrical and thermal safety, in preventing intraoperative hypothermia. We studied 18 patients undergoing abdominal surgery, allocated to one of two groups: in the control group, there was no prevention of intraoperative hypothermia (n = 8) and in the electric blanket group, two electric blankets covered the legs and upper body (n = 10). Anaesthesia duration was similar in the two groups (mean 201 (SEM 11) min), as was ambient temperature (20.5 (0.1) degrees C). Core temperature decreased during operation by 1.5 (0.1) degrees C in the control group, but only by 0.3 (0.2) degree C in the electric blanket group (P < 0.01). Five patients shivered in the control group compared with one in the electric blanket group (P < 0.05). We conclude that cutaneous warming with electric blankets was an effective means of preventing intraoperative hypothermia during prolonged abdominal surgery.      

Pethidine and skin warming to prevent shivering during endovascular cooling

We tested the efficacy of pethidine and cutaneous warming to prevent shivering during percutaneous cooling in unanaesthetized patients. Ten patients scheduled for cranial neurosurgery received pethidine infusion and skin warming. The Setpoint internal heat-exchanging catheter was inserted and cooling to 33.5 degrees C was started. Clonidine and chlorpromazine were given as "rescue medication" to treat shivering. General anaesthesia was planned to be induced after cooling was complete. Rewarming was initiated at dural closure. Three patients successfully completed the protocol, cooling to 33.8 degrees C at a median rate of 3.6 (range: 3.4-3.8) degrees C/h. Two patients cooled to 33.8 degrees C but required treatment for shivering (cooling rate: 2.9 [2.8-3.1] degrees C/h). Four patients failed to cool adequately because of refractory shivering (cooling rate: 20 [1.5-2.9] degrees C/h). One patient did not shiver and yet failed to cool adequately (cooling rate: 0.76 degrees C/h). Rewarming was at a rate of 26 (1.2-4.3) degrees C/h. There were no significant complications arising from catheter placement. The combination of skin warming and pethidine was not reliable enough to be recommended for use during endovascular cooling in unanaesthetized patients.     

A reusable, custom-made warming blanket prevents core hypothermia during major neonatal surgery

PURPOSE: To introduce a reusable model of neonatal forced air warming blanket for intraoperative use during major noncardiac neonatal surgery and to determine clinical efficacy of this reusable blanket compared with the commonly used disposable blankets. METHODS: Delivered air temperature and calorie uptake of standard thermal bodies within the reusable blankets, Bair Hugger(R) blanket model 530 and model 555 were studied. Also, an efficacy study was conducted in 90 neonatal patients scheduled for major noncardiac surgery comparing the reusable blanket, the Bair Hugger(R) blanket model 530 and passive heat conservation as a control. The covered reusable blanket was used as a rescue procedure if the core temperature was < 35.5 degrees C. RESULTS: Delivered air temperature and heat transfer from the covered reusable blanket did not differ significantly from those of the Bair Hugger(R) blanket model 530 and model 555 (despite 0.75 degrees C-1.2 degrees C of heat trapped under the sheet and 1.3 Kcal less energy transfer). Temperatures measured underneath patients (correlated to poorly perfused areas) were highest using the Bair Hugger(R) blanket model 555. The reusable blanket was efficacious in preventing intraoperative core hypothermia and not different from the Bair Hugger(R) blanket model 530. About 1/3 of the patients in the control group had presented a core temperature < 35.5 degrees C but were successfully rescued using the reusable blanket. No adverse events were associated with any of these warming methods. CONCLUSION: This study shows the clinical efficacy of our reusable blanket for the prevention of core hypothermia during major neonatal surgery, which is not different from commonly used disposable blankets.     

A quality improvement project incorporating preoperative warming to prevent perioperative hypothermia in major burns

Background

Patients with extensive burn injuries are susceptible to a host of accompanying adverse effects should they develop perioperative hypothermia, which occurs in up to ¼ of all major burn cases. This quality improvement project aimed to reduce the incidence of perioperative hypothermia to below 10% of cases in patients with major burn (Total Body Surface Area [TBSA]?>15%), within a one year period.

Comparison of forced-air warming and radiant heating during transurethral prostatic resection under spinal anaesthesia

Forced-air warming is commonly used to warm patients intraoperatively, but may not achieve normothermia during a short procedure. Comparative trials of a new radiant warming device in general anaesthesia (Suntouch, Fisher and Paykel, Auckland, New Zealand) have had conflicting results. We conducted a randomized controlled trial to compare the efficacy and thermal comfort of the Suntouch radiant warmer and forced-air warming in patients at high risk of hypothermia during neuraxial blockade. With ethics committee approval, 60 patients having transurethral resection of the prostate under spinal were randomized to either radiant warming or forced-air warming. All intravenous and irrigation fluids were warmed but pre-warming was not used. The final intraoperative rectal temperatures for the radiant warming and forced-air warming groups were 36.1 degrees C and 36.4 degrees C respectively (P= 0.03). A large proportion of patients in both groups (46% and 33% respectively, P=0.3) were hypothermic (<36 degrees C) on arrival in the post-anaesthesia care unit. No other patient variables were significantly different. Neither warming device reliably prevented hypothermia, although forced-air warming was slightly superior.