实用肝脏病杂志
實用肝髒病雜誌
실용간장병잡지
JOURNAL OF CLINICAL HEPATOLOGY
2014年
4期
384-387
,共4页
陈荣珠%王桂红%荚卫东%宇静%杜李兵
陳榮珠%王桂紅%莢衛東%宇靜%杜李兵
진영주%왕계홍%협위동%우정%두리병
肝癌%综合保温%快速康复外科
肝癌%綜閤保溫%快速康複外科
간암%종합보온%쾌속강복외과
Hepatocellular carcinoma%Comprehensive insulation measures%Fast-track surgery
观察综合保温措施对肝癌肝切除患者术中体温变化及术后恢复期的影响。方法将60例行肝切除治疗的原发性肝癌患者随机分为对照组30例，采取常规保温措施；和观察组30例，采取综合保温措施。观察两组患者术中体温变化、苏醒期寒战、躁动发生情况、术后咳嗽、发热发生率及首次下床活动时间、平均住院天数。结果观察组在肝实质离断后和苏醒期体温分别为（36.0±0.43）℃和（36.1±0.37）℃，对照组分别为（35.7±0.33）℃和（35.8±0.20）℃，观察组术中低体温发生率低于对照组（P＜0.01）；观察组苏醒期寒战和躁动的发生率分别为10.0%和13.3%，对照组分别为40.0%和36.7%，观察组术后咳嗽和发热的发生率分别为13.3%和10.0%，对照组分别为36.7%和33.3%，两组比较差异有显著的统计学意义（P＜0.05）；观察组术后首次下床活动时间为（26.8±3.6） h，对照组是（41.2±4.4） h，观察组术后平均住院（8.1±1.8） d，对照组是（10.2±1.6）d，两组比较差异有显著意义（P＜0.05）。结论综合保温措施能有效维持肝癌患者术中正常体温，减少苏醒期寒战、躁动及术后并发症的发生，在肝癌患者快速康复外科治疗中发挥了积极的作用。
觀察綜閤保溫措施對肝癌肝切除患者術中體溫變化及術後恢複期的影響。方法將60例行肝切除治療的原髮性肝癌患者隨機分為對照組30例，採取常規保溫措施；和觀察組30例，採取綜閤保溫措施。觀察兩組患者術中體溫變化、囌醒期寒戰、躁動髮生情況、術後咳嗽、髮熱髮生率及首次下床活動時間、平均住院天數。結果觀察組在肝實質離斷後和囌醒期體溫分彆為（36.0±0.43）℃和（36.1±0.37）℃，對照組分彆為（35.7±0.33）℃和（35.8±0.20）℃，觀察組術中低體溫髮生率低于對照組（P＜0.01）；觀察組囌醒期寒戰和躁動的髮生率分彆為10.0%和13.3%，對照組分彆為40.0%和36.7%，觀察組術後咳嗽和髮熱的髮生率分彆為13.3%和10.0%，對照組分彆為36.7%和33.3%，兩組比較差異有顯著的統計學意義（P＜0.05）；觀察組術後首次下床活動時間為（26.8±3.6） h，對照組是（41.2±4.4） h，觀察組術後平均住院（8.1±1.8） d，對照組是（10.2±1.6）d，兩組比較差異有顯著意義（P＜0.05）。結論綜閤保溫措施能有效維持肝癌患者術中正常體溫，減少囌醒期寒戰、躁動及術後併髮癥的髮生，在肝癌患者快速康複外科治療中髮揮瞭積極的作用。
관찰종합보온조시대간암간절제환자술중체온변화급술후회복기적영향。방법장60례행간절제치료적원발성간암환자수궤분위대조조30례，채취상규보온조시；화관찰조30례，채취종합보온조시。관찰량조환자술중체온변화、소성기한전、조동발생정황、술후해수、발열발생솔급수차하상활동시간、평균주원천수。결과관찰조재간실질리단후화소성기체온분별위（36.0±0.43）℃화（36.1±0.37）℃，대조조분별위（35.7±0.33）℃화（35.8±0.20）℃，관찰조술중저체온발생솔저우대조조（P＜0.01）；관찰조소성기한전화조동적발생솔분별위10.0%화13.3%，대조조분별위40.0%화36.7%，관찰조술후해수화발열적발생솔분별위13.3%화10.0%，대조조분별위36.7%화33.3%，량조비교차이유현저적통계학의의（P＜0.05）；관찰조술후수차하상활동시간위（26.8±3.6） h，대조조시（41.2±4.4） h，관찰조술후평균주원（8.1±1.8） d，대조조시（10.2±1.6）d，량조비교차이유현저의의（P＜0.05）。결론종합보온조시능유효유지간암환자술중정상체온，감소소성기한전、조동급술후병발증적발생，재간암환자쾌속강복외과치료중발휘료적겁적작용。
Objective To observe the effects of comprehensive insulation measures on changes of tempera-ture in patients with hepatocellular carcinoma (HCC) underwent hepatectomy and on postoperative recovery. Methods Sixty patients with HCC were randomly divided into control and observation group. 30 cases in control group were given regular insulation measures,while the other 30 cases in observation were treated with comprehen-sive insulation measures when they underwent hepatectomy. The temperature variation,emergence agitation and shiver,the incidence of postoperative complications such as cough and fever,the leaving bed time and average hospitalization days were compared between the two groups. Results The temperatures of patients in observation group after liver parenchyma transaction and during recovery period were(36.0±0.43)℃ and (36.1±0.37)℃,respec-tively,while they were (35.7±0.33)℃ and (35.8±0.20)℃ in control group,and the incidence of hypothermia during operation in observation group was significantly lower than that in the control group (P﹤0.01). The incidences of shiver and emergence agitation during recovery period were 10.0% and 13.3%,respectively in observation group, while they were 40.0% and 36.7%,respectively in control group. Incidence of postoperative cough and fever were 13.3% and 10.0%, respectively in observation group, while they were 36.7% and 33.3%,respectively in control group (P﹤0.05).The first leaving bed time was(26.8±3.57)hours in observation group,while it was (41.2±4.44) hours in control group(P﹤0.05). The mean hospital stay was(8.1±1.79)d in observation group,while it was (10.2± 1.59)d in control group (P﹤0.05). Conclusions Comprehensive insulation measures can effectively maintain rela-tively normal body temperature in patients with HCC during hepatectomy. It can also reduce the incidence of e-mergence agitation and shiver,as well as the occurrence of postoperative complications. Furthermore, comprehen-sive insulation measures play an active role in fast-track surgery (FTS) of patients with HCC.
