标题：手术室患者体温管理与患者全麻术后苏醒的相关性

      作者：李爱华 1，石孙君 2，候芳 1，胡丽萍 1    黄石市中心医院普爱院区手术室 1、急诊科 2，湖北 黄石 435000

      卷次： 2019年30卷9期

      【摘要】 目的 探讨手术室患者体温管理与患者全麻术后苏醒的相关性。方法 选取2018年1~9月期间于黄石市中心医院普爱院区行腹部全麻手术治疗的90例患者为研究对象，采用随机数表法将其分为对照组和观察组，每组45例，对照组患者采取常规护理，观察组患者在此基础上联合体温管理。比较两组患者术前、术毕的体温和应激反应指标(肾上腺素、去甲肾上腺素和C反应蛋白)的变化以及术后苏醒时间。结果 两组患者的性别、年龄、体质量等基线资料以及手术时间、术中出血量等手术相关指标比较差异均无统计学意义(P>0.05)；观察组患者术毕体温为(36.37±0.23)℃，高于对照组的(35.82±0.20)℃；苏醒时间为(48.27±8.50) min，短于对照组的(76.53±11.30) min，两组间比较差异均有统计学意义(P<0.05)；术后，两组患者的肾上腺素、去甲肾上腺素、C反应蛋白等应激反应指标水平均高于术前，差异均有统计学意义(P<0.05)；观察组患者的肾上腺素为(113.42±5.69) pmol/L，低于对照组的(175.60±6.23) pmol/L，去甲肾上腺素为(151.33±11.44) pmol/L，低于对照组的(170.85±12.85) pmol/L，C反应蛋白为(55.74±10.09) ng/L，低于对照组的(91.28±16.34) ng/L，两组间比较差异均有统计学意义(P<0.05)。结论 对全麻手术患者实施体温管理可有效缓解手术引起的应激反应，缩短术后苏醒时间。
      【关键词】 全身麻醉；手术室；体温管理；应激反应；苏醒时间
      【中图分类号】 R473.6 【文献标识码】 A 【文章编号】 1003—6350（2019）09—1222—03

Correlation between body temperature management in patients in operating room and recovery from generalanesthesia after operation.
LI Ai-hua 1, SHI Sun-jun 2, HOU Fang 1, HU Li-ping 1. Operation Room 1, EmergencyDepartment 2, The Puai Campus, Huangshi Central Hospital, Huangshi 435000, Hubei, CHINA
【Abstract】 Objective To investigate the correlation between body temperature management in patients in oper-ating room and recovery from general anesthesia after surgery. Methods A total of 90 patients were selected as sub-jects, who underwent abdominal general anesthesia in Puai Campus, Huangshi Central Hospital from January 2018 toSeptember 2018. They were divided into control group and observation group according to the random number method,with 45 cases in each group. The control group was given routine nursing, and the observation group received furthertemperature management on the basis of routine nursing. Comparison of two groups were explored on the change ofbody temperature and stress response indexes (adrenaline, norepinephrine and C-reactive protein) before and after sur-gery, and the time required for postoperative recovery. Results There were no significant differences in the baseline da-ta of gender, age, and body mass between the two groups, as well as the operation time, intraoperative bleeding volumeand other surgical related indicators (P>0.05). In the observation group, the body temperature was significantly higherthan that of the control group: (36.37±0.23) vs (35.82±0.20); and the recovery time was significantly shorter than that ofthe control group: (48.27±8.50) min vs (76.53±11.30）min; both differences were statistically significant (P<0.05). Afteroperation, the levels of stress response indicators such as adrenaline, norepinephrine, and C-reactive protein in the twogroups were significantly higher than those before operation (P<0.05). In the observation group, the adrenaline level waslower than that in the control group: (113.42±5.69) pmol/L vs (175.60±6.23) pmol/L; the norepinephrine level was lowerthan that in the control group: (151.33±11.44) pmol/L vs (170.85±12.85) pmol/L; the C-reactive protein was lower thanthat in the control group: (55.74±10.09) ng/L vs (91.28±16.34) ng/L; all differences were statistically significant betweenthe two groups (P<0.05). Conclusion The implementation of temperature management in patients undergoing generalanesthesia can effectively alleviate the stress response caused by operation and shorten the recovery time after operation.
      【Key words】 General anesthesia; Operating room; Temperature management; Stress response; Recovery time·护理·doi:10.3969/j.issn.1003-6350.2019.09.040