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腹部手术中患者的保暖方法。

Methods of patient warming during abdominal surgery.

机构信息

Department of Operation Room, The First Teaching Hospital of Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, China.

出版信息

PLoS One. 2012;7(7):e39622. doi: 10.1371/journal.pone.0039622. Epub 2012 Jul 11.


DOI:10.1371/journal.pone.0039622
PMID:22808045
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3394771/
Abstract

BACKGROUND: Keeping abdominal surgery patients warm is common and warming methods are needed in power outages during natural disasters. We aimed to evaluate the efficacy of low-cost, low-power warming methods for maintaining normothermia in abdominal surgery patients. METHODS: Patients (n = 160) scheduled for elective abdominal surgery were included in this prospective clinical study. Five warming methods were applied: heated blood transfusion/fluid infusion vs. unheated; wrapping patients vs. not wrapping; applying moist dressings, heated or not; surgical field rinse heated or not; and applying heating blankets or not. Patients' nasopharyngeal and rectal temperatures were recorded to evaluate warming efficacy. Significant differences were found in mean temperatures of warmed patients compared to those not warmed. RESULTS: When we compared temperatures of abdominal surgery patient groups receiving three specific warming methods with temperatures of control groups not receiving these methods, significant differences were revealed in temperatures maintained during the surgeries between the warmed groups and controls. DISCUSSION: The value of maintaining normothermia in patients undergoing abdominal surgery under general anesthesia is accepted. Three effective economical and practically applicable warming methods are combined body wrapping and heating blanket; combined body wrapping, heated moist dressings, and heating blanket; combined body wrapping, heated moist dressings, and warmed surgical rinse fluid, with or without heating blanket. These methods are practically applicable when low-cost method is indeed needed.

摘要

背景:在自然灾害发生时,保持腹部手术患者的体温是常见的,需要使用保暖方法。我们旨在评估低成本、低功耗的保暖方法在维持腹部手术患者正常体温方面的效果。

方法:本前瞻性临床研究纳入了 160 名择期腹部手术患者。应用了五种保暖方法:加热输血/输液与未加热;包裹患者与不包裹;应用湿润敷料,加热与不加热;手术野冲洗液加热与不加热;以及应用加热毯或不应用。记录患者的鼻咽和直肠温度以评估保暖效果。与未保暖的患者相比,保暖患者的平均温度有显著差异。

结果:当我们将接受三种特定保暖方法的腹部手术患者组与未接受这些方法的对照组的温度进行比较时,在全麻下接受腹部手术的患者在手术期间的体温维持方面,保暖组与对照组之间存在显著差异。

讨论:在全身麻醉下接受腹部手术的患者保持正常体温的价值已被接受。三种有效的经济实用的保暖方法是联合身体包裹和加热毯;联合身体包裹、加热湿润敷料和加热毯;联合身体包裹、加热湿润敷料和温热的手术冲洗液,有或没有加热毯。当确实需要低成本方法时,这些方法是实用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b34/3394771/02f75e23980e/pone.0039622.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b34/3394771/c94ac0264dfc/pone.0039622.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b34/3394771/02f75e23980e/pone.0039622.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b34/3394771/c94ac0264dfc/pone.0039622.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7b34/3394771/02f75e23980e/pone.0039622.g002.jpg

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本文引用的文献

[1]
Thermal suits as an alternative way to keep patients warm peri-operatively: a randomised trial.

Eur J Anaesthesiol. 2011-5

[2]
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Acta Biomed. 2007-12

[3]
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Taehan Kanho Hakhoe Chi. 2007-12

[4]
Randomized clinical trial of perioperative systemic warming in major elective abdominal surgery.

Br J Surg. 2007-4

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Ann N Y Acad Sci. 1997-3-15

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Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events. A randomized clinical trial.

JAMA. 1997-4-9

[10]
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N Engl J Med. 1996-5-9

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