腹腔冲洗温度及冲洗方式对胃肠手术术后体温及并发症的影响

目的探讨常温和近体温2种腹腔冲洗温度和不同冲洗方式对胃肠道手术患者体温及术后并发症的影响。方法 34例急诊胃肠道手术患者随机分为2组:对照组16例,关腹前用室温生理盐水冲洗碗冲洗腹腔,实验组18例用37℃生理盐水匀速冲洗腹腔,比较,2组麻醉复苏、术中体温及术后恢复情况。结果实验组所用冲洗量明显少于对照常温组(P<0.01),术后复苏拔除气管导管时间少于对照组(P<0.05);术中2组体温呈持续下降趋势(P<0.01),对照组术毕体温低于实验组(P<0.05);实验组术后1 h寒战发生率、烦躁躁动率、肠通气时间小于对照组(P<0.01,P<0.05),48 h内疼痛视觉模拟评分无差异(P>0.05)。结论加温盐水匀速冲洗腹腔有利于麻醉和肠蠕动恢复,对改善体温降低和减少术后并发症发生有一定作用。

Effect of peritoneal lavage temperature and lavage means on body temperature and complications after gastrointestinal surgery

Objective To explore the effect of different lavage temperature and lavage means on body temperature and postoperative complications after gastrointestinal surgery.Methods Thirty-four patients with emergency gastrointestinal operations were randomly divided into control group(n=16) and experiment group(n=18).The control group was lavaged with room temperature physiological saline before peritoneum saturation and the experiment group was lavaged with 37 ℃ physiological saline with constant speed.The body temperature during and after operation and anesthesia recovery were compared between the two groups.Results The lavage volume and anesthesia recovery time of the experiment group were obviously less than those of the control group(P<0.01,P<0.05).In both groups,the patients′body temperatures declined gradually during operation(P<0.01),but the temperature in the control group was lower than in the experiment group at the end of the operation(P<0.05).The incidence rates of shivering,dysphoria and flatulence of the experiment group were less than those of the control group(P<0.01,P<0.05).Visual analog scale(VAS) of pains within 48h showed no significant differences between the two groups(P>0.05).Conclusion Peritoneal lavage with warmer physiological saline provides more benefits for anesthesia and enterokinesia recovery,and it also can reduce the incidence of hypothermal conditions and postoperative complications.