围手术期低温对创伤病人全麻恢复期影响.doc

围手术期低温对创伤病人全麻恢复期影响[摘要] 目的：探讨创伤病人围手术期低温对全麻恢复期的影响及积极预防低温的临床价值。方法：60例创伤手术患者，采用随机双盲法分为两组，30例对照组采取常规处理，30例观察组积极采取低温预防措施，观察两组的麻醉苏醒时间、麻醉后寒战发生、麻醉后躁动发生及麻醉后低血压发生的情况。结果：观察组与对照组在30 min内麻醉苏醒例数间差异无统计学意义（P＞0.05），30~60 min苏醒例数有显著性差异（P＜0.05），60 min后苏醒有非常显著性差异（P＜0.01）；麻醉后寒战、麻醉后低血压、麻醉后躁动情况均有非常显著性差异（P＜0.01）。结论：创伤病人围手术期低温对机体危害很大，术中采取积极预防低温的措施可提高全麻质量，降低手术后并发症，提高患者的生存率。 [关键词] 围手术期；低温；创伤病人；全身麻醉；麻醉恢复期 [中图分类号]R614 [文献标识码]A [文章编号]1673-7210（2008）01（b）-015-03 The effect of hypothermia in perioperative period on trauma patients during athesthesia recovery stage XIAO Hua-xin,DAI Qi-ming,LINDong-li (The Department of Anesthesia,Dafeng Hospital in Chaoyang District,Shantou 515154,China) [Abstract]Objective: To discuss the effects of perioperative period hypothermia on patients with trauma during stage of general anesthesia recovery, and the clinical value of positive impact on the hypothermia prevention. Methods:60 cases of traumatic surgery patients were randomly, double-blindly divided into two groups, 30 cases in the control group dealt with conventional treatment, 30 cases in hypothermia group actively took preventive measures, the recoveries from anesthesia were observed，shivering after anesthesia occurred after anesthesia and anesthesia restless hypotension occurred in the situation.Results: The cases between observation group and the control group in 30 minutes had no significant difference (P0.05) during the stage of anesthesia recovery, while it was different in 30~60 minutes(P0.05)，具有可比性。观察手术结束后麻醉苏醒时间(指定向力恢复,能正确回答问题、举手、抬头等)、麻醉后寒战发生、麻醉后低血压发生、麻醉后躁动发生情况。 1.4 统计学方法 计量数据采用x±s表示,用SPSS 软件进行统计处理。组内比较采用单因素方差分析,组间比较采用t 检验,P 2.2 麻醉后寒战 对照组手术后寒战18例，观察组手术后寒战7例，两组数据有非常显著性差异（P＜0.01）。 2.3 麻醉后躁动 对照组手术后躁动12例，观察组手术后躁动2例，两组数据有非常显著性差异（P＜0.01）。 2.4 麻醉后低血压 对照组手术后低血压17例，观察组手术后低血压5例，两组数据有非常显著性差异（P＜0.01）。 3 讨论 3.1创伤病人手术期低温发生有多种原因 3.1.1术前热量丢失创伤可使正常的体温调节功能发生改变，并可阻断肌肉震颤反应，这种影响可在创伤发生的那一刻起就存在，如果创伤病人同时并存失血性休克时，组织摄取氧能力下降，机体产热减少，导致低温出现更为多见。创伤病人入院前暴露在低温环境，入院后过早脱去衣服而