三种加温输液方法加温效果及对腹腔镜手术患者影响.docVIP

三种加温输液方法加温效果及对腹腔镜手术患者的影响 　　[摘要] 目的 探讨3种不同加温方法对2～3 h时长腹腔镜手术患者的影响。方法 方便选取福建协和医院2016年8―12月共5个月中66例行腹腔镜手术的患者随机分为3组，每组22例，分为500HW组、250HW组及JW组。每例患者每10 min监测输入患者端液体温度tl及核心温度te直至拔管；同时纪录患者拔管时间、苏醒时间，3组患者所花费的经济成本。结果 与JW组相比， 500HW组患者50 min后患者te由36.45°C显著降低至35.67°C（P0.05） ，此后亦逐渐下降，至180 min时则显著降低至35.59°C（P0.05）； 250HW组患者100 min时te由36.40°C显著降低至35.61°C（P0.05） ，此后亦逐渐下降，至180 min时则显著降低至35.64°C（P0.05）。与250HW组相比，500HW组在全麻插管70 min为35.73°C，此后的各时间点也均显著降低（P0.05）；3组患者拔管时间：500HW组为18.2 min显著高于JW组的12.6 min和250HW组的13.8 min，而JW组和250HW组相比差异无统计学意义。结论 250 mL恒温箱加温组能提供和专用输液加温仪同样的加温效果，并在经济效益上提供潜在优势。 　　[关键词] 核心温度；腹腔镜手术；围术期低温 　　[中图分类号] R47 [文献标识码] A [文章编号] 1674-0742（2017）10（b）-0074-04 　　[Abstract] Objective This paper tries to explore the effect of three different heating methods on patients with 2 to 3 hours’ long laparoscopic surgery. Methods 66 patients underwent laparoscopic surgery from August to December 2016 in this hospital were conveniently divided into three groups（n=22）： 500HW group， 250HW group and JW group. Each patient was monitored for every 10 minutes of input fluid temperature tl and core temperature te until extubation； the patient’s extubation time， recovery time， and the economic cost of the three groups were recorded. Results Compared to the JW group， in the 500HW group， the patient’s te decreased significantly from 36.45℃ to 35.67℃（P0.05） at 50 min， and then decreased to 35.59℃（P0.05） at 180 min（P0.05）， and in 250HW group， the te was from 36.40℃ decreased to 35.61℃ at 100 min（P0.05）， and decreased as time went by， to 35.64℃ at 180 min（P0.05）. Compared with the 250HW group， the 500HW group was 35.73℃ in the general anesthesia for 70 min， and then decreased at each time point（P0.05）. The extubation time in the three groups： 500HW group was 18.2 min， significantly longer than that of the JW group of 12.6 min， and 250HW was 13.8 min， there was no significant difference between the JW group and the 250 HW group. Conclusion The 250HW group can provide the same warming effect as the J