基于围手术期低体温的影响因素构建管理策略

罗元元; 程帆; 蔡忠香; 宁金卓; 姚卫东

doi:10.16766/j.cnki.issn.1674-4152.003768

基于围手术期低体温的影响因素构建管理策略

doi: 10.16766/j.cnki.issn.1674-4152.003768

罗元元^{1, 2},
程帆^1,,
蔡忠香¹,
宁金卓¹,
姚卫东³

1.
武汉大学人民医院泌尿外科，湖北武汉 430000
2.
皖南医学院第一附属医院弋矶山医院重症监护室，安徽芜湖 241000
3.
皖南医学院第一附属医院弋矶山医院麻醉科

基金项目:

安徽省重点研究与开发计划项目 201904b11020014

详细信息

作者简介:
程帆，E-mail：urology1969@aliyun.com

中图分类号: R472.3 R619
计量
- 文章访问数: 23
- HTML全文浏览量: 10
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-01-13
- 网络出版日期: 2024-12-31

Developing clinical management strategies based on factors influencing perioperative hypothermia

1.
Department of Urology, People ' s Hospital of Wuhan University, Wuhan, Hubei 430000, China

摘要

摘要: 围手术期低体温(核心温度 < 36 ℃)是手术患者常见的并发症。一些以患者为中心的外部因素，如药物、合并症、创伤、环境温度、麻醉类型以及手术的范围和持续时间，均会影响核心体温。本文总结分析了麻醉前、麻醉中、麻醉后影响体温的各种因素以及围手术期低体温的不良后果。围手术期低体温不仅对人体各器官产生不良影响，还会减慢麻醉药物和止痛药物的代谢速度，导致麻醉效果不佳和副作用增加。同时，低体温还会抑制凝血酶原的活化，增加术后出血的风险。此外，低体温还会抑制机体的免疫功能，降低白细胞的活性，从而降低抵抗感染的能力，增加手术部位感染的概率。因此，在围手术期进行良好的体温管理至关重要。住院期间对患者进行良好的体温管理，可以降低围手术期低体温的发生风险。体温测量应使用准确、连续性探头，避免结果出现误差。围手术期体温管理包括一套适合个人需求的保温工具，保暖毯和床垫以及专用设备给予适当加热的输液非常重要。体温管理应遵循检查清单，并根据患者的要求和当地的可能性进行个体化。本研究整理了国内外关于围手术期低体温的不良后果、危险因素及预防策略等相关文献，以期为防治围手术期低体温提供可靠的方案。
- 低体温 /
- 围手术期 /
- 手术 /
- 体温管理
Abstract: Perioperative hypothermia (core temperature < 36 ℃) is a common complication in surgical patients, influenced by several patient-centered external factors such as medications, comorbidities, trauma, ambient temperature, type of anesthesia, and the extent and duration of the procedure. This article summarizes and analyzes various factors affecting body temperature before, during, and after anesthesia, as along with the adverse consequences of perioperative hypothermia. Perioperative hypothermia adversely impacts various organs, slows the metabolism of anesthetic drugs and analgesics, leading to reduced anesthesia effectiveness and increased side effects. Additionally, hypothermia inhibits prothrombin activation, increasing the risk of postoperative bleeding, and suppresses immune function, reducing the activity of white blood cells and the ability to resist infection, and increasing the probability of surgical site infections. Therefore, effective temperature management during the perioperative period is crucial. Accurate, continuous temperature monitoring using appropriate probes, and individualized warming tools, including the use of warm blankets, mattresses, and fluids heated through specialized equipment, are essential. Temperature management should be guided by a checklist and tailored to patient ' s requirements and local conditions. In this study, we have compiled a review of national and international literature on the adverse consequences, risk factors, and preventive strategies for perioperative hypothermia, aiming to provide reliable protocols for its prevention and management.
- Hypothermia /
- Perioperative /
- Surgery /
- Temperature management

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参考文献(40)

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