麻醉对患者体温影响.docVIP

麻醉对患者体温影响 　 作者;曾独娟，李爱民，冯国辉，雷志礼 ［摘要］ 目的 观察全身麻醉与硬膜外麻醉中体温的变化规律及低体温对麻醉中患者的影响，为加强术后体温护理提供依据。方法 选择全麻开腹手术患者50例，ASAⅠ~Ⅱ级。按照随机表法随机分为两组，全麻组25例，硬膜外组25例，两组生命体征均维持稳定，室内温度维持在22 ℃~25 ℃，常规铺单外不做保温处理。观察两组术前、术中及术毕体温变化；术毕时寒颤及躁动的发生率。结果 与术前比较，术中和术毕两组体温明显降低；组间比较差异有显著性；术毕完全清醒时全麻组比硬膜外组寒颤、躁动发生率高。结论 麻醉后食管温度会明显下降，但全麻时下降更明显。体温降低对寒颤、躁动的发生率有影响；麻醉手术中应监测体温，注意体温的保护，以降低上述反应的发生率。 ［关键词］ 低温；麻醉；手术 Effects of anesthesia on body temperature of patients ［Abstract］ Objective To observe the effects of anesthesia (general anesthesia and epidural block) on temperature of patients and to provide the basis for strengthening care in temperature of patient.Methods ASAⅠ~Ⅱ fifty patients undergoing abdominal surgery were divided into two groups (general anesthesia Ⅱ，n=25 and epidural group Ⅰ，n=25).Group Ⅰ and group Ⅱ temperature were used to assess core temperature monitored simultaneously.The temperatures were recorded during induction (T1)，10(T2)，30(T3)，60(T4)，90(T5)，120(T6)，150(T7) min after induction and at the end of surgery (T8).Proportion of occurrence of shiver and rashness was recorded at the consciousness of the end of surgery.Result In the group Ⅱ，the core temperature started decreasing after induction，it was significantly lower since 10 min after induction than pre-induction.Core temperature kept decreasing until the end of operation.In the group Ⅰ，core temperature started decreasing 30 min after induction，the core temperatures from 30 min after induction to the end of operation were significantly lower than those of pre-induction.The core temperature decreases more rapidly in the group Ⅱ than the group Ⅰ.Conclusion Both epidural and general anesthesia cause core hypothermia，but general anesthesia results in more lower core temperature than epidural anesthesia does.Hypothermia influences on proportion of occurrence of in shiver and rashness.Body temperature will be inspected during operation.Be careful while protecting body temperature.Cut down syndrome. ［Key words］ hypothermia;anesthesia;operati