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围手术期保暖在手术中的作用：一项系统综述。

The role of perioperative warming in surgery: a systematic review.

作者信息

Sajid Muhammad Shafique, Shakir Ali Jabir, Khatri Kamran, Baig Mirza Khurrum

机构信息

Department of Colorectal Surgery, Worthing Hospital, Worthing, West Sussex, United Kingdom.

出版信息

Sao Paulo Med J. 2009 Jul;127(4):231-7. doi: 10.1590/s1516-31802009000400009.

DOI:10.1590/s1516-31802009000400009
PMID:20011929
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11448715/
Abstract

OBJECTIVE

The objective of this review was to systematically analyze the trials on the effectiveness of perioperative warming in surgical patients.

METHODS

A systematic review of the literature was undertaken. Clinical trials on perioperative warming were selected according to specific criteria and analyzed to generate summative data expressed as standardized mean difference (SMD).

RESULTS

Twenty-five studies encompassing 3,599 patients in various surgical disciplines were retrieved from the electronic databases. Nineteen randomized trials on 1785 patients qualified for this review. The no-warming group developed statistically significant hypothermia. In the fixed effect model, the warming group had significantly less pain and lower incidence of wound infection, compared with the no-warming group. In the random effect model, the warming group was also associated with lower risk of post-anesthetic shivering. Both in the random and the fixed effect models, the warming group was associated with significantly less blood loss. However, there was significant heterogeneity among the trials.

CONCLUSION

Perioperative warming of surgical patients is effective in reducing postoperative wound pain, wound infection and shivering. Systemic warming of the surgical patient is also associated with less perioperative blood loss through preventing hypothermia-induced coagulopathy. Perioperative warming may be given routinely to all patients of various surgical disciplines in order to counteract the consequences of hypothermia.

摘要

目的

本综述的目的是系统分析围手术期保温对外科手术患者有效性的试验。

方法

进行了一项系统的文献综述。根据特定标准选择围手术期保温的临床试验，并进行分析以生成以标准化均差（SMD）表示的汇总数据。

结果

从电子数据库中检索到25项涵盖各外科领域3599例患者的研究。19项针对1785例患者的随机试验符合本综述要求。未保温组出现具有统计学意义的体温过低。在固定效应模型中，与未保温组相比，保温组疼痛明显减轻，伤口感染发生率更低。在随机效应模型中，保温组术后寒战风险也更低。在随机和固定效应模型中，保温组失血均显著减少。然而，各试验之间存在显著异质性。

结论

外科手术患者围手术期保温可有效减轻术后伤口疼痛、伤口感染和寒战。通过预防体温过低引起的凝血功能障碍，对手术患者进行全身保温还可减少围手术期失血。围手术期保温可常规应用于各外科领域的所有患者，以应对体温过低的后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/12d3b8272c36/1806-9460-spmj-127-04-231-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/ff81dc4f615e/1806-9460-spmj-127-04-231-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/1e2d79d3a6ed/1806-9460-spmj-127-04-231-gch1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/f7867c5671c2/1806-9460-spmj-127-04-231-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/dc8fa0f51782/1806-9460-spmj-127-04-231-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/2ec7e9f6ab6a/1806-9460-spmj-127-04-231-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/609b3fed614b/1806-9460-spmj-127-04-231-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/12d3b8272c36/1806-9460-spmj-127-04-231-gf6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/ff81dc4f615e/1806-9460-spmj-127-04-231-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/1e2d79d3a6ed/1806-9460-spmj-127-04-231-gch1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/f7867c5671c2/1806-9460-spmj-127-04-231-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/dc8fa0f51782/1806-9460-spmj-127-04-231-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/2ec7e9f6ab6a/1806-9460-spmj-127-04-231-gf4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/609b3fed614b/1806-9460-spmj-127-04-231-gf5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d98a/11448715/12d3b8272c36/1806-9460-spmj-127-04-231-gf6.jpg

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