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全身麻醉下小儿全口修复手术期间的体温管理

Body temperature management during pediatric full mouth rehabilitation surgery under general anesthesia.

作者信息

Lin Wei-Lin, Li Chung-Hsing, Cherng Chen-Hwan

机构信息

Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.

Division of Orthodontic, Dentofacial Orthopedic & Pediatric Dentistry, Department of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, ROC.

出版信息

J Dent Sci. 2018 Sep;13(3):263-266. doi: 10.1016/j.jds.2018.04.002. Epub 2018 Jun 7.

Abstract

BACKGROUND/PURPOSE: It was found that body temperature would be gradually increased during pediatric full mouth rehabilitation surgery. Although the etiology is unknown, here, we introduced an effective method to maintain normothermia during this kind of surgery.

MATERIALS AND METHODS

Following IRB approval, the medical records of pediatric patients who received full mouth rehabilitation surgery from Jan. 2014 through Jun. 2016 were collected. All the patients included were managed by a "tent-like draping" with a forced-air warmer (Life-Air 1000, Progressive Dynamics Inc.). The temperature of the forced-air was changed from 38 °C to cool ambient temperature when the body temperature higher than 36 °C. The body temperatures (preoperative, periodic during operation, and postoperative) and the maximum body temperature changes during operation were recorded. The data was compared with the results of a previous report.

RESULTS

Total 37 patients were enrolled. The maximum temperature change during operation was 2.08 ± 0.6 °C. The incidence of body temperature higher than 37.5 °C during operation was 10.8% (4/37). Compare to the previous report in which the patients received the same operation with ordinary surgical draping, the maximum temperature change and the incidence of body temperature higher than 37.5 °C during operation were significantly lower in patients received "tent-like draping" (2.08 ± 0.64 °C vs 2.50 ± 1.17 °C, p < 0.001; and 10.8% (4/37) vs 32.4% (11/34), p < 0.05, respectively).

CONCLUSION

The increase of body temperature during pediatric full mouth rehabilitation surgery can be effectively controlled by ambient forced-air cooling using tent-like draping.

摘要

背景/目的:研究发现,小儿全口修复手术过程中体温会逐渐升高。尽管病因不明,但在此我们介绍一种在此类手术中维持正常体温的有效方法。

材料与方法

经机构审查委员会(IRB)批准后,收集了2014年1月至2016年6月接受全口修复手术的小儿患者的病历。所有纳入的患者均采用“帐篷式覆盖”并使用强制空气暖风机(Life-Air 1000,Progressive Dynamics Inc.)进行处理。当体温高于36℃时,将强制空气的温度从38℃调至环境低温。记录体温(术前、术中定期及术后)以及术中体温的最大变化。将数据与之前一份报告的结果进行比较。

结果

共纳入37例患者。术中体温最大变化为2.08±0.6℃。术中体温高于37.5℃的发生率为10.8%(4/37)。与之前报告中接受相同手术但采用普通手术覆盖的患者相比,采用“帐篷式覆盖”的患者术中体温最大变化及体温高于37.5℃的发生率显著更低(分别为2.08±0.64℃对2.50±1.17℃,p<0.001;以及10.8%(4/37)对32.4%(11/34),p<0.05)。

结论

小儿全口修复手术中体温升高可通过使用帐篷式覆盖的环境强制风冷有效控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/25ed/6388863/58e969c40608/gr1.jpg

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