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强制空气加温预防腹腔镜手术患者围手术期低体温及相关并发症的疗效:一项随机对照试验。

Efficacy of forced-air warming for preventing perioperative hypothermia and related complications in patients undergoing laparoscopic surgery: A randomized controlled trial.

作者信息

Su Shu-Fen, Nieh Hsiao-Chi

机构信息

Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan (R.O.C).

Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan (R.O.C).

出版信息

Int J Nurs Pract. 2018 Oct;24(5):e12660. doi: 10.1111/ijn.12660. Epub 2018 Apr 23.

Abstract

BACKGROUND

Perioperatively, unexpected hypothermia may cause adverse surgical outcomes. However, few studies have explored the efficacy of forced-air warming in patients undergoing laparoscopic surgery.

AIM/OBJECTIVE: To determine the efficacy of forced-air warming for preventing perioperative hypothermia and complications in patients undergoing laparoscopic surgery.

METHODS

A total of 127 participants undergoing laparoscopic thoracic or abdominal surgery were recruited between January and November 2015. Participants were randomly allocated to intervention (forced-air warming, n = 64) and control groups (passive insulation, n = 63). Oesophageal core temperature was measured during surgery, whilst tympanic core temperature was measured every 30 minutes preoperatively and in the postanaesthesia care unit. Levels of shivering and pain, amount of bleeding, and adverse cardiac events were measured before the transfer from the postanaesthesia care unit. The generalized estimating equation was used for data analysis.

RESULTS

The intervention group had better warming efficacy than the control group between 90 and 330 minutes during surgery. The intervention group had fewer complications than the control group in terms of intraoperative bleeding, time to rewarm to 36°C, pain levels, and shivering levels in the postanaesthesia care unit.

CONCLUSION

Forced-air warming can increase warming efficacy and reduce complications of perioperative hypothermia in patients undergoing laparoscopic surgery.

摘要

背景

围手术期,意外低温可能导致不良手术结局。然而,很少有研究探讨强制空气加温在腹腔镜手术患者中的疗效。

目的

确定强制空气加温对预防腹腔镜手术患者围手术期低温及并发症的疗效。

方法

2015年1月至11月共招募了127例接受腹腔镜胸腹部手术的参与者。参与者被随机分为干预组(强制空气加温,n = 64)和对照组(被动保温,n = 63)。手术期间测量食管核心温度,术前及麻醉后护理单元每30分钟测量鼓膜核心温度。在从麻醉后护理单元转出前测量寒战和疼痛程度、出血量及不良心脏事件。采用广义估计方程进行数据分析。

结果

手术期间90至330分钟,干预组的加温效果优于对照组。干预组在术中出血、复温至36°C的时间、疼痛程度及麻醉后护理单元的寒战程度方面的并发症少于对照组。

结论

强制空气加温可提高加温效果,减少腹腔镜手术患者围手术期低温的并发症。

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