CAJ | 학술논문

目的探讨围手术期低温对重型创伤病人全麻苏醒的影响.方法采用随机双盲法将60例重型创伤手术患者平均分为对照组和保温组;对照组采取常规处理,保温组采取积极低温预防措施,观察两组全麻后的苏醒时间和苏醒期发生寒战、躁动及低血压的情况.结果保温组各时间点体温与开始麻醉时比较差异无显著性(P＞0.05),而与对照组比较差异有显著性(P＜0.05);对照组30 min内苏醒7例,30～60min苏醒16例,60min以上苏醒7例.保温组30min内苏醒7例,30～60min苏醒22例,60min以上苏醒1例.两组数据30 min内苏醒无差异性(P＞0.05),30～60 min内苏醒有差异性(P＜0.05),60 min后苏醒有显著差异性(P＜0.01);对照组苏醒后寒战发生18例,保温组7例,两组数据异性有显著差(P＜0.01);对照组苏醒后躁动发生12例,保温组3例,两组数据差异有显著性(P＜0.01);对照组苏醒后低血压发生17例,保温组5例,两组数据有显著差异性(P＜0.01).结论重型创伤病人围手术期低温对机体危害很大,术中采取积极预防低温的措施可提高全麻质量,降低苏醒期并发症,提高患者的生存率.
목적 탐토위수술기저온대중형창상병인전마소성적영향.방법 채용수궤쌍맹법장60례중형창상수술환자평균분위대조조화보온조;대조조채취상규처리,보온조채취적겁저온예방조시,관찰량조전마후적소성시간화소성기발생한전、조동급저혈압적정황.결과 보온조각시간점체온여개시마취시비교차이무현저성(P＞0.05),이여대조조비교차이유현저성(P＜0.05);대조조30 min내소성7례,30～60min소성16례,60min이상소성7례.보온조30min내소성7례,30～60min소성22례,60min이상소성1례.량조수거30 min내소성무차이성(P＞0.05),30～60 min내소성유차이성(P＜0.05),60 min후소성유현저차이성(P＜0.01);대조조소성후한전발생18례,보온조7례,량조수거이성유현저차(P＜0.01);대조조소성후조동발생12례,보온조3례,량조수거차이유현저성(P＜0.01);대조조소성후저혈압발생17례,보온조5례,량조수거유현저차이성(P＜0.01).결론 중형창상병인위수술기저온대궤체위해흔대,술중채취적겁예방저온적조시가제고전마질량,강저소성기병발증,제고환자적생존솔.
Objective The explore the effects of perioperative low temperature to regaining consciousness of the severe traumatic patients with general anesthesia. Methods 60 cases of severe traumatic surgery patients, with stochastic double blind method, were divide into two groupg, 30 cases in control group adopted conventional processing,30 cases of heat preservation group took the positive low temperature preventive measures, the conditions of awakening time, shiver during consciousness time, dysphoria and hypotension were observed in the awakening period after general anesthesia. Results There was no significant difference between the body temperature at each time point of heat preservation group and that at the anesthesia beginning(P＞ 0.05), but when compared to that in the control group,there was significant difference (P＜ 0.05); in the control group, 7 cases of consciousness were found in 30 minutes after anesthesia, 16 cases found in 30 to 60 minutes, 7 cases in more than 60 minutes. While in the heat preservation group, 7 cases of consciousness were found in 30 minutes after anesthesia, 22 cases found in 30 to 60 minutes, 1case in more than 60 minutes. There was no significant difference in consciousness conditions 30 minutes after anesthesia(P＞ 0.05), there was significant difference in those of 30 to 60 minutes after anesthesia(P＜ 0.05), and there was very significant difference in those of 60 minutes after anesthesia(P ＜ 0.01). The data of shiver after consciousness (18 cases in control, 7 in heat preservation group), dysphoria (12 in control, 3 in heat preservation group) and hypotension (17 in control, 5 in heat preservation group) after anesthesia in these two groups had very significant differences(P＜ 0.01). Conclusion The perioperative low temperature can make great damage to severe traumatic patients, it will improve the general anesthesia quality, reduce the complications during conscious period,and raise the survival rate of the patients to make active measures for preventing the perioperative low temperature.