Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Department of Intensive Care Unit, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, China.
Clinics (Sao Paulo). 2020 Apr 17;75:e1639. doi: 10.6061/clinics/2020/e1639. eCollection 2020.
The enhanced recovery after surgery (ERAS) protocol recommends prevention of intraoperative hypothermia. However, the beneficial effect of maintaining normothermia after radical cystectomy has not been evaluated. This study aimed to investigate the efficacy of fluid warming nursing in elderly patients undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy.
A total of 108 patients with bladder cancer scheduled to undergo DaVinci robotic-assisted laparoscopic radical cystectomy were recruited and randomly divided into the control group (n=55), which received a warming blanket (43°C) during the intraoperative period and the warming group (n=53), in which all intraoperative fluids were administered via a fluid warmer (41°C). The surgical data, body temperature, coagulation function indexes, and postoperative complications were compared between the two groups.
Compared to the control group, the warming group had significantly less intraoperative transfusion (p=0.028) and shorter hospitalization days (p<0.05). During the entire intraoperative period (from 1 to 6h), body temperature was significantly higher in the warming group than in the control group. There were significant differences in preoperative fibrinogen level, white blood cell count, total bilirubin level, intraoperative lactose level, postoperative thrombin time (TT), and platelet count between the control and warming groups. Multivariate linear regression analysis demonstrated that TT was the only significant factor, suggesting that the warming group had a lower TT than the control group.
Fluid warming nursing can effectively reduce transfusion requirement and hospitalization days, maintain intraoperative normothermia, and promote postoperative coagulation function in elderly patients undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy.
术后加速康复（ERAS）方案建议预防术中低体温。然而，根治性膀胱切除术后保持正常体温的有益效果尚未得到评估。本研究旨在探讨达芬奇机器人辅助腹腔镜根治性膀胱切除术老年患者中应用液体加温护理的效果。
共纳入 108 例拟行达芬奇机器人辅助腹腔镜根治性膀胱切除术的膀胱癌患者，随机分为对照组（n=55）和加温组（n=53）。对照组术中使用保温毯（43°C），加温组所有术中液体均通过液体加温器（41°C）输注。比较两组的手术数据、体温、凝血功能指标和术后并发症。
与对照组相比，加温组术中输液量显著减少（p=0.028），住院天数缩短（p<0.05）。整个术中期间（1-6 小时），加温组的体温明显高于对照组。对照组和加温组术前纤维蛋白原水平、白细胞计数、总胆红素水平、术中乳糖水平、术后凝血酶时间（TT）和血小板计数存在显著差异。多变量线性回归分析表明，TT 是唯一的显著因素，提示加温组 TT 低于对照组。
液体加温护理可有效减少输液需求和住院天数，维持术中正常体温，促进达芬奇机器人辅助腹腔镜根治性膀胱切除术老年患者术后凝血功能。
