引用本文:王丽,徐芹,李龙柏.[cn_title][J].[journal_cn_name],2019,[volume]([issue]):424-427.[点击复制]
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全麻患者术中应用多模式保温干预对术中体温及术后认知功能影响的观察
王丽,徐芹,李龙柏
0
(南京中医药大学附属盐城市中医院)
摘要:
目的 探讨全麻患者术中应用多模式保温干预对术中体温及术后认知功能影响。方法 将盐城市中医院收治的100例拟行全麻手术治疗的患者依照密封信封法分配原则分为观察组(n=50)和对照组(n=50)。对照组手术期间给予常规保温处理;观察组给予多模式保温处理。对比两组患者术中不同时间点的体温,观察拔管时间、麻醉完全清醒时间、麻醉恢复室(PACU)滞留时间,以及寒战、手术部位感染(SSI)发生率,比较术前及术后60 min患者的认知功能。结果 观察组麻醉诱导前(T0)、麻醉后60 min(T1)、术毕(T2)、离开PACU前5 min(T3)时的体温对比差异无统计学意义(P>0.05);对照组T1~T3的体温呈逐渐下降趋势,差异有统计学意义(P<0.05)。观察组T1~T3的体温显著高于对照组(P<0.05);观察组的拔管时间、麻醉完全清醒时间及PACU滞留时间均短于对照组(P<0.05),寒战、SSI发生率也均低于对照组(P<0.05);观察组术前、术后60 min的定向力、短时记忆力、回忆能力、计算能力、语言和模仿能力及总分对比差异无统计学意义(P>0.05),对照组术后60 min的上述认知功能评分均显著低于术前和观察组同时间点,差异有统计学意义(P<0.05)。结论 多模式保温处理应用于全麻手术患者,可降低术中低体温发生率,提高患者术后康复效果,改善其术后认知功能损害。
关键词:  全麻手术  术中低体温  多模式保温  认知功能  术中护理
DOI:
基金项目:
Effects of multimodal warming regimen on intraoperative body temperature and postoperative cognitive function in patients with general anesthesia
wangli,徐芹,李龙柏
(Yancheng Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Traditional Chinese Medicine)
Abstract:
Objective To explore the effects of multimodal warming regimen on intraoperative body temperature and postoperative cognitive function in patients with general anesthesia.Methods One hundred patients who were scheduled to undergo general anesthesia in Yancheng Hospital of Traditional Chinese Medicine were divided into the observation group (n=50) and the control group (n=50) by the method of sealed envelope. The patients in control group were treated with routine warming during operation, while the patients in observation group were given multimodal warming. The body temperatures at different time points during operation were compared between the two groups. The extubation time, complete recovery time from anesthesia, postanesthesia care unit (PACU) stay and incidence rates of chills and surgical site infection (SSI) were compared. The cognitive function was compared before operation and at 60 min after operation.Results There was no statistically significant difference in the body temperature of the observation group before anesthesia induction (T0), 60 min after anesthesia (T1), at the end of operation (T2) and 5 min before leaving PACU (T3) (P>0.05). The body temperatures at T1-T3 in the control group showed a gradually decline trend (P<0.05), and the body temperatures at T1-T3 in the observation group were significantly higher than those in the control group (P<0.05). The extubation time, complete recovery time from anesthesia and PACU stay in the observation group were shorter than those in the control group (P<0.05) And the incidence rates of chills and SSI were lower than those in the control group (P<0.05). There were no significant differences in the scores of directional force, shortterm memory, recall ability, calculation ability, language and imitation ability and total score in the observation group before operation compared with those at 60 min after operation (P>0.05), and the above cognitive function scores in the control group at 60 min after operation were significantly lower than those before operation and those in observation group at the same time point (P<0.05). Conclusions Multimodal warming for patients with general anesthesia can effectively reduce the incidence rate of intraoperative hypothermia, improve postoperative rehabilitation effects and ease the damage of postoperative cognitive function.
Key words:  General anesthesia  Intraoperative hypothermia  Multimodal warming  Cognitive function  Intraoperative nursing

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