Research practice of using two heating blankets in combination to affect intraoperative temperature and postoperative resuscitation in patients undergoing endoscopic three-incision radical resection of esophageal cancer
10.3760/cma.j.cn211501-20200303-00824
- VernacularTitle:上下联合保温对全腔镜三切口食管癌根治术患者体温及复苏影响的研究实践
- Author:
Yanfang BAI
1
;
Mingtian LI
;
Zhouru ZHAN
;
Huiying QIN
Author Information
1. 中山大学肿瘤防治中心手术麻醉科，广州 510060
- From:
Chinese Journal of Practical Nursing
2020;36(33):2600-2606
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of three heating methods on intraoperative temperature and postoperative resuscitation in patients undergoing three-incision radical resection of esophageal cancer under full endoscope.Methods:A total of 145 patients undergoing endoscopic three-incision radical resection of esophageal cancer were randomized to receive forced-air warming respectively on the under-body blanket(UB group, n=48), over-body blanket (OB group, n=48), underbody blanket in combination with over-body blanket(Combined group, n=49). The nasopharyngeal temperature were recorded at the time of entering the operating room, at the beginning of the intubation, at the beginning of the operation and every 30min after the operation, at the end of the operation. The incidence of hypothermia, hypothermia related adverse reactions and postoperative resuscitation indicators of the three groups were compared. Results:During the operation, the patients' temperature fluctuation showed two processes of decrease and two processes of increase. The temperature of Combined group showed a lower fall and a faster rise. The average temperature of the Combined group were higher than the other two group at each time point from the beginning of the intubation, the incidence of hypothermia was 4.08% (2/49), which was lower than the OB group [22.92% (11/48)] and the UB group [18.75% (9/48)], The difference was statistically significant ( χ2 value was 7.397, P=0.025). The temperature of the UB group was (36.52±0.18),(36.31±0.35)℃ at the beginning of intubation and at the end of the operation, respectively, which were higher than that of the OB group (36.44±0.15),(36.13±0.32)℃ ( t value was 2.393, 3.723, P < 0.05). The temperature comfort score of the combined group was 7.81±0.52, higher than that of the other two groups ( F value was 19.962, P<0.01), and the scores of chills, agitation and chills in the recovery period were lower than that of the other two groups ( F value was 8.186, 6.705, 4.051, all P < 0.05). The extubation time and the waking time of the combined group was (15.90±2.97)min, (31.47±4.42)min, respectively, which were both lower than those of the other two groups ( F value was 69.094, 114.549, P < 0.01). Conclusions:In endoscopic three-incision radical resection of esophageal cancer, combined heating makes the patients' temperature rise rapidly to offset the loss of heat, which is conducive to maintain a stable temperature. At the same time, the incidence of intraoperative hypothermia, postoperative chills and agitation is reduced, the temperature comfort of patients is improved, the extubation time and waking time are shortened, which is conducive to promote postoperative recovery of patients, thus reduce postoperative hypothermia related complications.
