剖腹产围术期体温保护的临床随机对照研究

Clinical randomized controlled study on perioperative body temperature protection in caesarean section

摘要:

目的 观察围术期保温对剖腹产手术中产妇体温下降的影响。方法 选取120 例蛛网膜下腔麻醉 下行剖腹产的患者将其随机分为实验组（S 组）和对照组（C 组），每组60 例。实验组（S 组）：在麻醉之前 30 min 使用加温服给予加温，温度设定为40℃。对照组（C 组）：麻醉前30 min 不给予加温服保温。记录两 组血氧饱和度（SpO2）、血压、心率（HR）及鼓膜室温度。麻醉前30 min 测量两组体温为基础体温，麻醉后 每15 min 测量1 次体温，两组进行比较。结果 两组基础体温比较无差异（P <0.05），但麻醉后手术时两组体 温差异有统计学意义（P <0.05）。实验组基础体温为（36.6±0.3℃），麻醉时体温为（36.5±0.3℃）最后下降 至（36.1±0.2℃），对照组基础体温为（36.4±0.4）℃，麻醉时体温为（36.3±0.3）℃，最后下降至（35.4±0.4℃） （P <0.05）。两组血液动力学比较，差异无统计学意义（P <0.05）。结论 腰麻前30 min 积极主动的升温能够 预防足月孕妇行剖腹产手术中的体温下降。

Abstract:

Objectives To investigate the effect of perioperative thermal insulation on maternal hypothermia during caesarean section. Methods A total of 120 patients receiving cesarean section under spinal anesthesia were randomly divided into two groups (n = 60). Patients in group S were kept warm by a warm coat for 30 minutes (40 degree) before anesthesia. Patients in group C (control group) did not receive any thermal protection before anesthesia. Body temperature at the 30th minute before anesthesia was measured as baseline temperature, and then was recorded every 15 minutes until the end of surgery. Blood oxygen saturation, blood pressure, heart rate and tympanic membrane temperature of the two groups were recorded. Results The baseline temperature was (36.6 ± 0.3)℃ and (36.5 ± 0.3)℃ for group S and group C, respectively. There was no obvious difference in baseline temperature between the two groups. Body temperature was dropped down at the end of anesthesia in both two group, with (36.1 ± 0.2)℃ in group S and (35.4 ± 0.4)℃ in group C. Patients in group C experienced more dramatic decrease of body temperature compared with group S (P < 0.05). No significant difference in hemodynamics between the two groups was founded. Conclusion Warming up for 30 minutes before anesthesia can prevent the dropdown of body temperature for women undergoing cesarean section.