综合干预措施在预防深度肌松下腹腔镜直肠癌术中低体温的效果分析

杨明明; 朱秋燕; 顾斌; 汪露萍

doi:10.16766/j.cnki.issn.1674-4152.003712

综合干预措施在预防深度肌松下腹腔镜直肠癌术中低体温的效果分析

doi: 10.16766/j.cnki.issn.1674-4152.003712

浙江省肿瘤医院手术室，浙江杭州 310022

基金项目:

浙江省医药卫生科技计划项目 2022KY694

详细信息

通讯作者:
杨明明，E-mail：yangmingming8703@163.com

中图分类号: R735.37
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- 文章访问数: 23
- HTML全文浏览量: 11
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- 被引次数: 0
出版历程
- 收稿日期: 2024-01-02
- 网络出版日期: 2024-12-28

Analysis of the effect of comprehensive intervention measures in preventing hypothermia during laparoscopic rectal cancer surgery under deep muscle relaxation

Operating Room of Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, China

摘要

摘要: 目的探究深度肌松下腹腔镜直肠癌手术通过综合干预措施对术中低体温的预防作用。方法选择2022年6月—2023年1月浙江省肿瘤医院收治的直肠癌120例患者纳入研究分析，通过计算机自动生成的随机数将研究对象分为研究组和对照组，每组各60例。研究组患者给予综合干预措施，对照组则给予常规保温。比较组间术中及术后恢复体温的变化及其他治疗相关变量间的差异。结果研究组和对照组间的基本人口学特征与术前放疗化疗情况、美国麻醉医师协会分级、总输液量和尿量等手术相关指标比较差异均无统计意义(P>0.05)。麻醉诱导后所有患者的核心体温均呈现出下降趋势；研究组和对照组患者在术中不同时间点体温差异均有统计学意义(P < 0.001)；在手术进行0.5~3.0 h，研究组患者的体温均显著高于对照组(P < 0.001)。恢复室内所有患者的核心体温在总体上均呈上升趋势；研究组和对照组患者在术后恢复室不同时间点的体温差异均有统计学意义(P < 0.001)；在术后恢复室的不同时间点，研究组患者的体温均显著高于对照组(P < 0.001)。此外，研究组患者达到Aldrete评分10分的平均时间显著短于对照组(P < 0.001)。对照组内9例患者表现出寒战，研究组内仅为2例。结论综合干预措施能够有效预防深度肌松下腹腔镜直肠癌手术低体温的发生率，缩短恢复时间。
- 直肠癌 /
- 深度肌松 /
- 腹腔镜 /
- 手术 /
- 低体温
Abstract: Objective To investigate the efficacy of comprehensive intervention measures in preventing intraoperative hypothermia in laparoscopic rectal cancer surgery under deep muscle relaxation. Methods A total of 120 patients with rectal cancer treated at Zhejiang Cancer Hospital between June 2022 and January 2023 were selected for inclusion in the research analysis. The subjects were randomly assigned to either the study group or the control group, with 60 cases in each group. The study group received comprehensive intervention measures, while the control group was administered routine heat preservation. The differences in intraoperative and postoperative recovery body temperature changes and other treatment-related variables were compared between the two groups. Results No significant differences were observed between the study group and the control group with regard to basic demographic characteristics, preoperative radiotherapy and chemotherapy, American society of aneshesiologists classification, total infusion volume, and urine volume (P>0.05). Following the administration of anaesthetic agents, a decline in core body temperature was observed in all patients. A statistically significant difference in body temperature was observed between the study group and the control group at various time points during the surgical procedure (P < 0.001). A significant difference in body temperature was observed between the study and control groups during the 0.5-3.0 h following surgery (P < 0.001). The overall trend for the core body temperature of all patients in the recovery room was an increase. A statistically significant difference was observed in body temperature between the study group and the control group at various time points during the postoperative recovery period (P < 0.001). At different time points within the postoperative recovery room, the body temperature of patients in the study group was found to be significantly higher than that of the control group (P < 0.001). Furthermore, the mean time to achieve an Aldrete score of 10 was significantly shorter in the study group than in the control group (P < 0.001). Nine patients in the control group exhibited chills, whereas only two patients in the study group did so. Conclusion The implementation of comprehensive intervention and nursing measures has been demonstrated to effectively prevent the incidence of hypothermia in patients undergoing deep muscle paralysis laparoscopic rectal cancer surgery, while also reducing the recovery time.
- Rectal cancer /
- Deep muscle relaxation /
- Laparoscopy /
- Surgery /
- Hypothermia

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图 1 术中不同时间点研究组与对照组核心体温比较

注：同时间点组间比较，^aP < 0.05。F_交互=48.099，P_交互 < 0.001；F_时间=86.055，P_时间 < 0.001；F_组间=2 536.831，P_组间 < 0.001。

Figure 1. Comparison of core body temperature between the study group and the control group at different time points during operation

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表 1 2组人口学信息及手术相关指标比较

Table 1. Comparison of demographic information and surgery-related indicators between the two groups

项目	研究组(n=60)	对照组(n=60)	统计量	P值
年龄[M(P₂₅, P₇₅)，岁]	54.5(49.3, 58.0)	53.0(48.3, 58.0)	-0.754^a	0.451
性别[例(%)]			0.033^b	0.855
男性	31(51.7)	30(50.0)
女性	29(48.3)	30(50.0)
身高[M(P₂₅, P₇₅)，cm]	165.0(162.3, 168.8)	165.0(162.0, 168.8)	-0.562^a	0.574
体重[M(P₂₅, P₇₅)，kg]	61.0(60.0, 64.8)	62.0(60.0, 68.8)	-1.169^a	0.243
术前放疗[例(%)]			0.069^b	0.793
否	52(86.7)	51(85.0)
是	8(13.3)	9(15.0)
术前化疗[例(%)]			0.063^b	0.803
否	51(85.0)	50(83.3)
是	9(15.0)	10(16.7)
合并症[例(%)]			1.690^b	0.194
否	39(65.0)	32(53.3)
是	21(35.0)	28(46.7)
ASA分级[例(%)]			1.234^b	0.267
Ⅰ	38(63.3)	32(53.3)
Ⅱ	22(36.7)	28(46.7)
麻醉时间[M(P₂₅, P₇₅)，min]	179.0(174.3, 183.5)	176.0(174.0, 179.0)	-2.050^a	0.040
手术时间[M(P₂₅, P₇₅)，min]	165.0(162.0, 168.0)	162.0(160.0, 166.0)	-3.137^a	0.002
总输液量(x±s，mL)	1 544.5±175.5	1 582.5±185.5	-1.153^c	0.251
尿量[M(P₂₅, P₇₅)，mL]	343.5(295.0, 357.5)	338.0(296.0, 355.8)	-0.071^a	0.943

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表 2 研究组和对照组患者术后恢复室体温比较(x ±s，℃)

Table 2. Comparison of body temperature of patients within the postoperative recovery room between the study group and control group (x±s, ℃)

术后恢复室时间(min)	研究组(n=60)	对照组(n=60)	F值	P值
0	36.02±0.07	35.60±0.19	250.982	< 0.001
15	36.23±0.09^a	35.76±0.13^a	553.355	< 0.001
30	36.22±0.09^a	35.66±0.13^b	831.082	< 0.001
45	36.30±0.07^ac	35.86±0.20^abc	252.399	< 0.001
60	36.54±0.07^abcd	36.03±0.09^abcd	1204.687	< 0.001
注：F_时间=242.875，P_时间 < 0.001；F_组间=2718.932，P_组间 < 0.001；F_交互=7.497，P_交互 < 0.001。与同组术后恢复室0 min比较，^aP < 0.05；与同组术后恢复室15 min比较，^bP < 0.05；与同组术后恢复室30 min比较，^cP < 0.05；与同组术后恢复室45 min比较，^dP < 0.05。

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