Sohn Vance Y, Steele Scott R
Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.
Clin Colon Rectal Surg. 2009 Feb;22(1):21-7. doi: 10.1055/s-0029-1202882.
Unrecognized and untreated intraoperative hypothermia remains a common avoidable scenario in the modern operating room. Failure to properly address this seemingly small aspect of the total operative care has been shown to have profound negative patient consequences including increased incidence of postoperative discomfort, surgical bleeding, requirement of allogenic blood transfusion, wound infections, and morbid cardiac events. All of these ultimately lead to longer hospitalizations and higher mortality. To avoid such problems, simple methods can be employed by the surgeon, anesthesiologist, and ancillary personnel to ensure euthermia. Similarly, another effortless method to potentially improve surgical outcomes is the liberal use of supplemental oxygen. Promising preliminary data suggests that high-concentration oxygen during and after surgery may decrease the rate of surgical site infections and gastrointestinal anastomotic failure. The precise role of supplemental oxygen in the perioperative period represents an exciting area of potential research that awaits further validation and analysis. In this article, the authors explore the data regarding both temperature regulation and supplemental oxygen use in an attempt to define further their emerging role in the perioperative care of patients undergoing colorectal surgery.
在现代手术室中，未被识别和未得到治疗的术中低体温仍是一种常见的可避免情况。未能妥善处理手术整体护理中这个看似微不足道的方面，已被证明会给患者带来严重的负面后果，包括术后不适、手术出血、异体输血需求、伤口感染及严重心脏事件的发生率增加。所有这些最终都会导致住院时间延长和死亡率升高。为避免此类问题，外科医生、麻醉医生及辅助人员可采用简单方法来确保正常体温。同样，另一种可能改善手术效果的简便方法是大量使用补充氧气。有前景的初步数据表明，手术期间及术后使用高浓度氧气可能会降低手术部位感染率和胃肠道吻合口失败率。补充氧气在围手术期的确切作用是一个令人兴奋的潜在研究领域，有待进一步验证和分析。在本文中，作者探讨了有关体温调节和补充氧气使用的数据，试图进一步明确它们在接受结直肠手术患者围手术期护理中的新作用。
