复合保温措施对剖宫产产妇围术期低体温和寒战发生的影响

目的 探讨复合保温措施防止剖宫产产妇围术期低体温和寒战发生的作用,为建立围术期患者有效的保温模式提供实验依据.方法 选择健康初产妇120例,将其随机分为对照组（62例）和观察组（58例）,对照组在手术恒温床上施行剖宫产术并采取常规保温方式,观察组在此基础上采取调整手术室温度,静脉输注液、冲洗液和纱布预温,使用强制充气加温毯以及减少身体裸露面积等的复合保温措施;监测产妇入室至手术结束的口腔温度和寒战状况,并进行统计学比较.结果 对照组产妇手术20 min、手术40 min和手术结束时的体温均低于入室时（P＜0.01）,观察组产妇手术20 min、手术40 min和手术结束时的体温与入室时比较,差异无统计学意义（P＞0.05）,且均分别高于同时间点的对照组（P＜0.05）;对照组的低体温发生率显著高于观察组（51.6％ vs 3.4％,P＜0.01）;两组产妇均未发生3、4级寒战,对照组的1、2级寒战发生率显著高于观察组（22.6％vs 3.4％,P＜0.01）.结论 复合保温措施能有效维持剖宫产产妇围术期体温恒定,预防术中低体温和寒战的发生.

Effect of composite thermal insulation measure on occurrence of hypothermia and shivering for delivery woman with caesarean section in the perioperative period

Objective To investigate the role of composite thermal insulation measure on prevention of hypothermia and shivering for delivery woman with caesarean section in the perioperative period to provide the experimental basis for establishing an effective thermal insulation measure for patients in the perioperative period. Methods 120 healthy primiparae were selected and divided into the control group （n=62） and observation group （n=58） randomly.Caesarean section of the control group was performed on thermostatic bed of operation and the control group was given the con- ventional insulation method,based on the above,composite thermal insulation measure comprised of operating room tem- perature regulation,pre-temperature treatment of intravenous infusion of fluid,flushing fluid and gauze,using the forced air warming blanket,and reducing body exposed area and so on was performed in the observation group.Oral tempera- ture and shivering state of puerperant were monitored during caesarean section,and then the data were analyzed statis- tically. Results Body temperature of the control group at 20 min,40 min of operation and at the end of operation were sharply lower than those entering the operating room （P〈0.01）.There was no statistical difference of body temperature in the observation group at 20 rain,40 min of operation and at the end of operation compared with entering the operating room （P〉0.05）,and the body temperature of the observation group was notably higher than that of the control group at the same time point （P〈0.05）.Incidence rate of hypothermia in the control group was obviously higher than that of the observation group （51.6% vs 3.4%,P〈0.01）.There was no shivering in grade 3 and 4 in delivery woman of the two groups;incidence rate of shivering in grade 1 and 2 of the control group was obviously higher than that of the observation group （22.6% vs 3.4% ,P〈0.01）. Conclusion Composite thermal insulation measure can effectively maintain monothermia of delivery woman with cae