摘要
目的:观察体温保护对卵巢癌手术患者围术期加速康复的影响。方法:回顾性选取2023年1月-2024年5月本院接受开腹手术的卵巢癌患者92例,其中2023年1月-2023年8月收治的术中未采用体温保护干预45例(未干预组),2023年9月-2024年5月收治的术中采用体温保护干预47例(干预组)。比较两组手术情况,术中体温[入室时(T0)、麻醉30min(T1)、麻醉60min(T2)、麻醉120min(T3)、离室时(T4)],术中低体温率、低体温发生时间、苏醒期躁动率、住院时间及并发症率。检测两组手术前后血乳酸水平。结果:干预组手术时间、术中输液量、术中出血量与未干预组无差异(P>0.05)。两组T0时体温无差异(P>0.05),T1~T4时两组体温均低于T0时但干预组均高于未干预组(P<0.05)。两组术毕即刻、术毕3h时血乳酸均高于T0时但干预组(1.35±0.25 mmol/L、1.65±0.44 mmol/L)均低于未干预组(1.84±0.61 mmol/L、2.52±0.78 mmol/L)(均P<0.05)。干预组术中低体温率(8.5.%)、苏醒期躁动率(2.1%)低于未干预组(26.7%、13.3%),低体温发生时间(122.5±8.7min)晚于未干预组(48.3±17.8min),住院时间(9.7±2.4d)短于未干预组(11.1±3.3d),并发症总发生率(10.6%)低于未干预组(28.9%)(均P<0.05)。结论:体温保护可有效减少卵巢癌患者围术期体温波动,降低低体温与苏醒期躁动发生率,减轻机体应激反应,利于康复加速。
Objective:To observe the impact of the body temperature protection for patients with ovarian cancer surgery on their perioperative accelerated recovery.Methods:92 patients with ovarian cancer who had undergone open surgery in the hospital from January 2023 to May 2024 were selected in this study retrospectively.Among these patients,45 cases without the body temperature protection during surgery from January 2023 to August 2023 were included in group A,and 47 cases with the body temperature protection during surgery from September 2023 to May 2024 were included in group B.The surgical conditions,the intraoperative body temperature at admission(T0),at 30 min of anesthesia(T1),at 60 min of anesthesia(T2),at 120 min of anesthesia(T3)and at leaving the operation room(T4),the intraoperative hypothermia rate,the time of the hypothermia occurrence,the rate of agitation during the awakening period,the duration of the hospital stay and the rate of complications of the patients were compared between the two groups.The blood lactate levels of the patients in both groups before and after surgery were detected.Results:There were no significant differences in the operation time,the intraoperative infusion volume and the intraoperative blood loss of the patients between the two groups(P>0.05).There was no significant difference in the body temperature of the patients at T0 between the two groups(P>0.05).The body temperature of the patients in the two groups at T1-T4was significantly lower than that of the patients at T0,and the body temperature of the patients in group B at T0-T4was significantly higher than that of the patients in group A(P<0.05).The blood lactic acid levels of the patients in both groups at the end of operation and at 3hafter operation were significantly higher than those at T0,but which(1.35±0.25mmol/L,1.65±0.44mmol/L)of the patients in group B at the end of operation and at 3hafter operation were significantly lower than those(1.84±0.61mmol/L and 2.52±0.78mmol/L)of the patients in group A(all P<0.05).The intraoperative hypothermia rate(8.5%)and the emergence agitation rate(2.1%)of the patients in group B were significantly lower than those(26.7%and 13.3%)of the patients in group A.The time of the hypothermia occurrence(122.5±8.7min)of the patients in group B was significantly later than that(48.3±17.8min)of the patients in group A,and the duration of the hospital stay(9.7±2.4d)of the patients in group B was significantly shorter than that(11.1±3.3d)of the patients in group A.The total incidence of the complications(10.6%)of the patients in group A was significantly lower than that(28.9%)of the patients in group A(all P<0.05).Conclusion:The body temperature protection of the patients in the ovarian cancer operation can effectively reduce their body temperature fluctuation during the perioperative period,can decrease the incidences of the hypothermia and the agitation during the awakening period,can alleviate the stress response of the body,and can facilitate the postoperative accelerated recovery.
作者
张晴晴
王薇
孔慧
王丽芬
ZHANG Qingqing;WANG Wei;KONG Hui;WANG Lifen(School of Nursing,Zhejiang Chinese Medical University,Hangzhou,Zhejiang Province,310053;Zhejiang Cancer Hospital)
出处
《中国计划生育学杂志》
2025年第2期444-448,453,共6页
Chinese Journal of Family Planning
基金
2023浙江省医药卫生科技计划(2023KY616)。
关键词
卵巢癌手术
围术期体温保护
加速康复
苏醒期躁动
血乳酸
并发症
Ovarian cancer surgery
Body temperature protection during the perioperative period
Accelerated recovery
Aagitation during the awakening period
Blood lactic acid
Complication
