充气式保温毯在结肠癌根治术中的应用

目的研究结肠癌根治术手术患者术中采用充气式保温毯预防术中体温下降的应用价值。方法选取择期行全身麻醉的结肠癌根治术患者60例，采用随机数字表法分为保温组和对照组，对照组患者在室温下手术，除手术期间加温静脉用液、血和加温腹腔冲洗液外，没有加用充气式保温毯。保温组患者除手术期间加温静脉用液、血和加温腹腔冲洗液外，加用充气式保温毯，观察两组患者体温、血浆凝血酶原时间（ PT）、部分激活凝血活酶时间（ APTT）、纤维蛋白原（ FIB）、PLT的变化。结果对照组与保温组，手术开始时体温分别为（36．4＆#177;0．3），（36．3＆#177;0．4）℃，差异无统计学意义（t＝0．319，P＞0．05），手术结束时对照组体温为（35．5＆#177;0．4）℃，明显低于保温组的（36．5＆#177;0．3）℃（t ＝4．984，P＜0．05）。对照组患者术后6 h PT、APTT分别为（14．1＆#177;1．3），（35．6＆#177;4．3） s，明显长于术前的（10．5＆#177;1．6），（28．1＆#177;4．1）s，差异有统计学意义（t值分别为5．897，6．654；P＜0．05），对照组患者术后6 h FIB、PLT分别为（2．7＆#177;0．2）g/L，（135．7＆#177;31．9）＆#215;109/L，显著低于术前的（3．2＆#177;0．2）g/L，（213．1＆#177;36．1）＆#215;109/L，差异有统计学意义（ t值分别为7．574，4．753；P＜0．05）。保温组患者术后6 h PT、APTT分别为（10．8＆#177;1．2），（29．0＆#177;2．8）s，与术前的（10．6＆#177;1．4），（28．3＆#177;3．7）s相比，差异无统计学意义（t值分别为0．564，0．975；P＞0．05），保温组患者术后6 h FIB、PLT分别为（3．2＆#177;0．2）g/L，（198．6＆#177;36．3）＆#215;109/L，与术前的（3．2＆#177;0．1） g/L，（211．1＆#177;33．2）＆#215;109/L相比，差异无统计学意义（t值分别为0．879，0．654；P＞0．05）。结论结肠癌根治术中使用充气式保温毯可减少围手术期低体温及低体温相关并发症的发生。

Forced-air warming blanket application of nursing research in the operation of radical resection of colon ;cancer

Objective To probe into the value of forced-air warming blanket to prevent the body temperature drop of surgical patients during operation .Methods A total of 60 colon cancer patients accepting radical operation under general anesthesia were randomly divided into test and control group .During the operation, control group cases received operation at room temperature .Except during the heating operation of intravenous fluid , blood and warming peritoneal lavage fluid ,with no use of forced-air warming blanket .Patients of test group had received their operation on the forced-air warming blanket in surgical bed , except during the heating operation of intravenous fluid , blood and warming peritoneal washings . Then changes of body temperature, PT, APTT, PLT of the two group cases were observed .Results Control group compared with test group, no significant difference was found at the beginning of the operation temperature （36.4 ＆#177;0.3 vs 36.3 ＆#177; 0.4）℃,t=0.319, P＆gt;0.05], the operation temperature at the end of the control group was significantly lower than that in test group （35.5 ＆#177;0.4 vs 36.5 ＆#177;0.3）℃,t=4.984, P＆lt;0.05].In control group,PT （14.1 ＆#177; 1.3 vs 10.5 ＆#177;1.6）s] and APTT（35.6 ＆#177;4.3 vs 28.1 ＆#177;4.1） s] of postoperation 6 hours were significantly longer than that preoperation（t=5.897,6.654;P＆lt;0.05）,and FIB （2.7 ＆#177;0.2 vs 3.2 ＆#177;0.2）g/L] and PLT （135.7 ＆#177;31.9 vs 213.1 ＆#177;36.1） ＆#215;109/L] of postoperation 6 hours were significantly lower than that preoperation （t=7.574,4.753;P＆lt;0.05）,PT（10.8 ＆#177;1.2 vs 10.6 ＆#177;1.4）s],APTT（29.0 ＆#177;2.8 vs 28.3 ＆#177; 3.7）s],FIB（3.2 ＆#177;0.2 vs 3.2 ＆#177;0.1） g/L],PLT（198.6 ＆#177;36.3 vs 211.1 ＆#177;33.2） ＆#215;109/L] had no significant differences before and after surgery in the test group （ t =0.564, 0.975;P ＆gt;0.05 ）;. Conclusions During the radical resection of colon cancer ,forced-air warming blanket can effectively reduce the occurrence of peri-operation period of low temperature and low temperature related complication .