摘要
目的探讨不同保温措施对胃肠手术老年患者麻醉恢复期术后应激的影响。方法选择我院2018年1月至2018年8月全身麻醉下行胃肠手术后带气管管道入麻醉恢复室(PACU)老年患者60例。按照随机数字法分为对照组(A组)和观察组(B组)。A组使用常规保温措施,即棉被覆盖,B组在常规保温措施基础上使用充气式升温毯(44℃)进行保温。于入PACU时(T0)、入PACU后20min(T1)、入后40min(T2)、出PACU时(T3)观察MAP、HR和T;于T0、T3、术后24h(T4)静脉采血测血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶原时间(TT)、肾上腺素(E)和去甲肾上腺素(NE);同时记录两组患者麻醉苏醒时间、气管拔管时间、以及PACU滞留时间。结果 T1和T2时B组T明显高于A组(P<0.05);T3和T4时B组E和NE明显低于A组(P<0.05);PACU滞留时间比较:B组苏醒时间、拔管时间、PACU滞留时间明显低于A组(P<0.05)。两组患者其余指标差异无统计学意义(P>0.05)。结论充气式升温毯预防全身麻醉恢复期老年胃肠手术患者术后低体温,降低术后应激反应,缩短苏醒时间,减少PACU滞留时间。
Objective To explore the effects of different thermal insulation measures on postoperative stress in elderly patients undergoing gastrointestinal surgery during the recovery from general anesthesia. Methods 60 elderly patients were selected to be admitted to the anesthesia recovery room(PACU) with tracheal tube after gastrointestinal surgery under general anesthesia in our hospital from January 2018 to August 2018. The patients were divided into control group(group A) and observation group(group B) by random number method. Group A with conventional heat preservation measures,namely,quilt cover,group B on the basis of conventional heat preservation measures using inflatable heating blanket for thermal insulation(44℃). MAP,HR and T were observed when entering the PACU(T0),20 min after entering PACU(T1),40 min after entering PACU(T2),and out of PACU(T3). Plasma prothrombin time(PT),activated partial thrombin time(APTT),prothrombin time(TT),epinephrine(E) and norepinephrine(NE)were measured at T0,T3 and 24 h(T4) after operation. At the same time,anesthesia waking time,tracheal extubation time and PACU retention time were recorded in both groups. Results T in group B was significantly higher than that in group A at T1 and T2(P<0.05). At T3 and T4,E and NE in group B were significantly lower than those in group A(P<0.05). Comparison of PACU residence time:the recovery time,extubation time and PACU residence time in group B were significantly lower than those in group A(P<0.05). There was no significant difference in other indicators between the two groups(P>0.05). Conclusion Inflatable heating blanket can prevent postoperative hypothermia in elderly patients recovering from gastrointestinal surgery under general anesthesia,reduce postoperative stress response,shorten waking time,and reduce PACU retention time.
作者
严金秀
张学康
余志峰
许庆琴
郭余大
朱小华
凌华
YAN Jinxiu;ZHANG Xuekang;YU Zhifeng(The First Affiliated Hospital of Nanchang University,Nanchang 330006 China;Jiangxi People's Hospital,Nanchang 330006,China)
出处
《江西医药》
CAS
2019年第4期329-331,347,共4页
Jiangxi Medical Journal
基金
江西省卫生和计划生育委员会课题,编号20175166
关键词
麻醉恢复期
保温措施
老年患者
应激反应
Anesthesia recovery period
Insulation measure
Elderly patients
Stress response
