摘要
目的探讨暖风机腹股沟复温法对体外循环术后低体温患者复温效果的影响。方法将100例体外循环术后低体温患者按照随机数字表法分为观察组和对照组各50例,对照组给予暖风机足底复温法,观察组采用暖风机腹股沟复温法。分别于复温后10 min(T10)、30 min(T30)、60 min(T60)、90 min(T90)记录2组患者的膀胱温、腋温、血乳酸含量,比较2组复温时间和复温后90 min引流量。结果T10、T30、T60、T90时观察组膀胱温分别为(34.44±0.98)、(35.44±1.12)、(36.71±1.16)、(37.60±1.45)℃,腋温分别为(34.30±1.85)、(35.31±1.36)、(36.38±1.57)、(37.28±1.72)℃;对照组膀胱温分别为(34.18±1.56)、(36.91±1.61)、(37.70±1.29)、(37.40±1.10)℃,腋温分别为(34.45±1.03)、(36.30±1.25)、(37.70±1.23)、(37.19±1.31)℃;2组T10和T90时膀胱温和腋温差异无统计学意义(P>0.05),在T30和T60时观察组膀胱温和腋温低于对照组(t值为5.309、4.073,P<0.01),2组膀胱温和腋温存在时间点和组间的交互效应(F值为11.768、6.030,均P<0.01)。T10、T30、T60、T90时观察组乳酸值分别为(0.68±0.13)、(0.88±0.20)、(0.93±0.21)、(1.03±0.39)mmol/L,对照组分别为(0.67±0.11)、(0.92±0.14)、(1.19±0.14)、(1.56±0.19)mmol/L,2组T10、T30时乳酸值差异无统计学意义(P>0.05),在T60和T90时观察组乳酸值明显低于对照组(t值为7.276、8.640,P<0.01),2组乳酸值存在时间点和组间的交互效应(F值为36.034,P<0.01)。观察组复温后90 min引流量为(95.44±15.24)ml,明显低于对照组(106.08±25.56)ml,差异有统计学意义(t值为2.528,P<0.05)。结论暖风机腹股沟复温法可使体外循环术后低体温患者体温有效、匀速上升,是一种安全有效的复温方法。
Objective To investigate the rewarming effect of groin-mediated forced-air warming system in patients with hypothermia after cardiopulmonary bypass.Methods A total of 100 hypothermia patients after cardiopulmonary bypass were divided into observation group and control group with 50 cases each by random digits table method.Patients in control group received pelma-mediated forced-air warming system,observation group carried out groin-mediated forced-air warming system.The levels of bladder temperature,axillary temperature and lactate concentration were monitored at 10 min(T10),30 min(T30),60 min(T60),90 min(T90)after rewarming in two groups,rewarming time and drainage volume at 90 min after rewarming between two groups was also compared.Results Bladder temperature in observation group were(34.44±0.98),(35.44±1.12),(36.71±1.16),(37.60±1.45)℃at T10,T30,T60,T90,axillary temperature were(34.30±1.85),(35.31±1.36),(36.38±1.57),(37.28±1.72)℃,bladder temperature and axillary temperature in control group were(34.18±1.56),(36.91±1.61),(37.70±1.29),(37.40±1.10)℃and(34.45±1.03),(36.30±1.25),(37.70±1.23),(37.19±1.31)℃,respectively.There was no significant difference in bladder temperature and axillary temperature at T10 and T90(P>0.05),however,the bladder temperature and axillary temperature was significantly decreased in observation group compared to control group at T30 and T60(t value was 5.309,4.073,P<0.01),in addition,there were crossover effect of time and grouping factor in bladder temperature and axillary temperature(F value was 11.768,6.030,all P<0.01).Serum lactate concentration in observation group were(0.68±0.13),(0.88±0.20),(0.93±0.21),(1.03±0.39)mmol/L at T10,T30,T60,T90,and(0.67±0.11),(0.92±0.14),(1.19±0.14),(1.56±0.19)mmol/L in control group,there was no significant difference in lactate concentration at T10 and T30(P>0.05),however,the lactate concentration was significantly decreased in observation group compared to control group at T60 and T90(t value was 7.276,8.640,P<0.01),in addition,there were crossover effect of time and grouping factor in lactate concentration(F value was 36.034,P<0.01).Drainage volume at 90 min after rewarming were(95.44±15.24)ml in observation group,(106.08±25.56)ml in control group,the difference was significant between two groups(t value was 2.528,P<0.05).Conclusions Groin-mediated forced-air warming system can effectively and uniformly rewarming the body temperature of patients with hypothermia after cardiopulmonary bypass and served as a potential rewarming strategy.
作者
刘艳梅
许旸晖
史加海
王金凤
Liu Yanmei;Xu Yanghui;Shi Jiahai;Wang Jinfeng(Department of Cardiovascular Surgery Intensive Care Unit,Affiliated Hospital of Nantong University,Nantong 226001,China)
出处
《中国实用护理杂志》
2020年第10期736-740,共5页
Chinese Journal of Practical Nursing
基金
南通大学附属医院科研项目(Tfh 1706)。
关键词
体外循环
暖风机复温
膀胱温
腋温
Cardiopulmonary bypass
Forced-air rewarming
Bladder temperature
Axillary temperature
