CAJ | 학술논문

目的：探讨大肝癌切除术中及术后麻醉复苏期低体温对患者术后康复的影响，为临床体温护理提供科学依据。方法将160例术中及术后麻醉复苏期的大肝癌切除术患者，按低体温强度分为A1组（体温<35℃，41例）、A2组（体温35~35.5℃，85例）、A3组（体温35.6~35.9℃，34例）；同时根据低体温持续时间分为B1组（时间<1 h，35例）、B2组（时间为1~2 h，47例）、B3组（时间>2 h，78例）。比较各组麻醉清醒时间、术后第1天腹腔引流量、术前及术后第5天肝功能、切口愈合及术后住院时间。结果 A1组较A2组、A3组麻醉清醒时间、切口愈合时间及术后住院时间均延迟（P<0.05）；A3组较A1组、A2组术后第1天腹腔引流量减少、术后第5天谷丙转氨酶（ALT）和谷草转氨酶（AST）降低（P<0.05）；B3组较B1组、B2组麻醉清醒时间延长、术后第5天ALT和AST恢复减慢；B3组较B1组术后第1天腹腔引流量增加（P<0.05）。B1组、B2组、B3组的切口愈合时间及术后住院时间比较差异无统计学意义（P>0.05）。结论体温约35益对患者的术后康复影响较大，应加强术中及术后麻醉复苏期患者的体温监测，及早发现低体温并采取积极有效的复温措施，减少低体温对患者术后的不良影响，促进患者康复。
목적：탐토대간암절제술중급술후마취복소기저체온대환자술후강복적영향，위림상체온호리제공과학의거。방법장160례술중급술후마취복소기적대간암절제술환자，안저체온강도분위A1조（체온<35℃，41례）、A2조（체온35~35.5℃，85례）、A3조（체온35.6~35.9℃，34례）；동시근거저체온지속시간분위B1조（시간<1 h，35례）、B2조（시간위1~2 h，47례）、B3조（시간>2 h，78례）。비교각조마취청성시간、술후제1천복강인류량、술전급술후제5천간공능、절구유합급술후주원시간。결과 A1조교A2조、A3조마취청성시간、절구유합시간급술후주원시간균연지（P<0.05）；A3조교A1조、A2조술후제1천복강인류량감소、술후제5천곡병전안매（ALT）화곡초전안매（AST）강저（P<0.05）；B3조교B1조、B2조마취청성시간연장、술후제5천ALT화AST회복감만；B3조교B1조술후제1천복강인류량증가（P<0.05）。B1조、B2조、B3조적절구유합시간급술후주원시간비교차이무통계학의의（P>0.05）。결론체온약35익대환자적술후강복영향교대，응가강술중급술후마취복소기환자적체온감측，급조발현저체온병채취적겁유효적복온조시，감소저체온대환자술후적불량영향，촉진환자강복。
Objective To investigate the effects of intraoperative and postanesthesia hypothermia on recovery in patients with large hepatocellular carcinoma (HCC) undergoing hepatectomy. Methods A total of 160 hypothermic patients were divided into three groups according to the severity of hypothermia:T<35℃(n=41,group A1),35-35.5℃(n=85,A2)and 35.6-35.9℃(n=34,A3).In a separate analysis,patients were divided into three groups according to the duration of hypothermia::<1 h(n=35,B1),1-2 h(n=47,B2),and>2 h (n=78,B3).Postanesthesia recovery time,first postoperative peritoneal drainage volume,5th postoperative ALT and AST levels,wound healing time and duration of postoperative hospitalization were compared among the groups. Results Anesthestia recovery time was longer in A1 than in the other A groups,and longer in B3 than in the other B groups.First postoperative peritoneal drainage was higher and 5th postoperative ALT levels were lower in A1 and B3 than in the respective A and B groups(P<0.05).Group A3 showed the lowest 5th postoperative ALT level and longest wound healing and postoperative hospitalization(P<0.05). Conclusion Body temperature<35℃significantly affects patient recovery.Greater attention should be paid to body temperature monitoring and effective rewarming in order to minimize postoperative complications due to hypothermia.