充气式温毯预保温联合液体加温对肺叶切除术患者体温及热舒适度的影响

目的本研究拟探讨充气式温毯预保温联合液体加温对胸科全麻肺叶切除术患者体温及热舒适度的影响。方法择期行胸腔镜(VATS)肺叶切除术患者46例,随机分为预保温(充气式温毯)+液体(温箱)保温组(T)和对照组(C),每组23例,记录预保温前后、麻醉过程中、术毕及进出麻醉术后恢复室(PACU)时患者鼓膜温及术后寒战、热舒适度、恢复室停留时间。结果在麻醉后1、2、3 h和术毕时4个时间点,与对照组相比,保温组患者术中的核心体温下降幅度小,更趋于稳定(P0.01);保温组患者术后低体温发生率,寒战发生率均较低(8.7%比56.5%,4.3%比34.8%,P0.05);保温组患者热舒适度评分高于对照组(8.52±0.94比7.65±0.83,P0.01)。结论术前预保温联合液体保温可维持全麻肺叶切除术患者术中体温平稳,降低低体温及寒战发生,提高热舒适度,为患者提供有效的体温保护。

Effects of forced-air prewarming combined with fluid warmingon body temperature and thermal comfort in patients undergoing lobectomy

Objective To investigate the effects of forced-air prewarming combined with fluid warming on body temperature and thermal comfort in patients undergoing lobectomy.Methods Forty six patients scheduled for video-assisted thoracoscopic surgery (VATS) of lobectomy were randomized into two groups (n=23 each):warming group (group T) and the control group (group C).Forced-air prewarming combined with infusion heating was applied in the warming group,while only conventional passive warming was used in control group.The tympanic membrane temperatures were recorded before prewarming,after prewarming, during the anesthesia, the end of operation, the moment in and out of the postanesthesia care unit (PACU).Incidence of postoperative shivering, thermal comfort and the time in the PACU were recorded.Results The warming group had a slower temperature decrease at 1,2, 3 hours after operation and end of operation(P< 0.01), warming group had significantly lower incidence of hypothermia and shivering than control group(8.7% vs 56.5%, 4.3% vs 34.8%,P<0.05),and the thermalcomfort score was higher in warming group than in control group(8.52±0.94 vs 7.65±0.83,P<0.05).Conclusions Forced-air prewarming combined with fluid warming has significant clinical effects to stabilize patients` body temperature during operations,to reduce the incidence of hypothermia and shivering and to improve the thermal comfort, which provides a simple and effective temperature protection strategy for patients undergoing lobectomy.