【摘要】：目的:探討動(dòng)力充氣型升溫儀聯(lián)合輸液加溫對(duì)胃癌根治術(shù)患者蘇醒及內(nèi)穩(wěn)態(tài)的影響。方法:選擇全麻下行胃癌根治術(shù)患者80例,隨機(jī)分為保溫組和對(duì)照組,采用順阿曲庫銨、咪達(dá)唑侖、芬太尼、依托咪酯進(jìn)行麻醉誘導(dǎo),保溫組采用動(dòng)力充氣型升溫儀聯(lián)合輸液加溫進(jìn)行保溫,對(duì)照組不進(jìn)行保溫。分別監(jiān)測(cè)和記錄兩組患者在入室(T1)及麻醉誘導(dǎo)后60min(T2)、120min(T3)和術(shù)畢(T4)的鼻咽溫度。觀察兩組患者蘇醒及拔管時(shí)間和不良反應(yīng)發(fā)生情況;不同時(shí)間點(diǎn)(T1、T2、T3、T4)采集橈動(dòng)脈血測(cè)定血糖、血紅蛋白、血乳酸含量及pH值。結(jié)果:(1)與T1比較,對(duì)照組在T2～T4時(shí)的鼻咽溫均明顯降低(P0.001);兩組患者入室體溫的比較無統(tǒng)計(jì)學(xué)差異(P0.05);對(duì)照組在T2～T4時(shí)的鼻咽溫明顯低于保溫組同時(shí)間點(diǎn)(P0.001)。(2)與保溫組比較,對(duì)照組患者自主呼吸恢復(fù)、睜眼及拔管時(shí)間均明顯延長,術(shù)后寒顫、躁動(dòng)和低血壓發(fā)生率均明顯升高(P0.05,P0.001)。(3)與T1比較,兩組患者在T2～T4時(shí)的G1u和Lac含量均升高(P0.05),且對(duì)照組顯著高于相應(yīng)的保溫組(P0.05);與T1比較,兩組患者在T2～T4時(shí)的pH值和THb含量均降低(P0.05),且對(duì)照組顯著低于相應(yīng)的保溫組(P0.05)。結(jié)論:采用動(dòng)力充氣型升溫儀聯(lián)合輸液加溫應(yīng)用于胃癌根治術(shù)患者,能夠有效地維持體溫,減少低體溫的發(fā)生;體溫保護(hù)可以提高蘇醒質(zhì)量,維持內(nèi)環(huán)境的相對(duì)穩(wěn)定。
[Abstract]:Objective: to investigate the effect of dynamic inflatable warming instrument combined with infusion warming on the recovery and homeostasis of patients with gastric cancer after radical operation. Methods: 80 patients with gastric cancer undergoing radical gastrectomy under general anesthesia were randomly divided into heat preservation group and control group. The patients were anesthetized with cisatracurium, midazolam, fentanyl and etomidate. The heat preservation group was heated by dynamic inflatable warming instrument combined with infusion heating, while the control group was not. The nasopharyngeal temperature of 60min (T2) 120min (T3) and post-operation (T4) were monitored and recorded in both groups. The recovery time, extubation time and adverse reaction of the two groups were observed, and the blood glucose, hemoglobin, lactate content and pH value of radial artery blood were collected at different time points (T1T2T2T3T4). Results: (1) compared with T1, the nasopharyngeal temperature in the control group was significantly lower than that in the control group at T2~T4 (P0.001), and there was no significant difference in the body temperature between the two groups (P0.05), and the nasopharyngeal temperature in the control group was significantly lower than that in the thermal insulation group at the same time point (P0.001). (2) compared with the thermal insulation group (P0.001). (2). In the control group, the recovery of spontaneous respiration, the time of opening eyes and extubation were significantly prolonged, and the incidence of chills, restlessness and hypotension were significantly increased after operation (P0.05). (_ 3, P0.001). (_ 3) compared with T1, respectively. The levels of G1u and Lac in both groups increased at T2~T4 (P0.05), and the control group was significantly higher than the corresponding heat preservation group (P0.05); compared with T1, the pH value and THb content of the two groups in T2~T4 decreased (P0.05), and the control group was significantly lower than the corresponding thermal insulation group (P0.05). Conclusion: the application of dynamic inflatable warming instrument combined with infusion warming in patients undergoing radical gastrectomy can effectively maintain the body temperature and reduce the occurrence of hypothermia, and the temperature protection can improve the recovery quality and maintain the relative stability of the internal environment.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R614;R735.2

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