经尿道前列腺切除术术中充气加温毯体温保护效果及对患者凝血功能的影响

摘要

Objective To investigate the body temperature protective effect of inflatable warming blanket during transurethral prostatectomy (TURP) and its influence on the coagulation function of the patients.Methods From February 2016 to July 2017,126 patients with benign prostatic hyperplasia in Changhai Hospital were selected and divided into the control group and the observation group,with 63 cases in each group.The control group was given conventional body temperature intervention,while the observation group was given inflatable warming blanket on the bases of control group.The perioperation body temperature,coagulation function before and after surgery and the incidence of complications were compared between the two groups.Results The one-way analysis of variance showed that there were statistically significant differences in the two groups before and after different time points of anesthesia (F=46.24,92.86,P ＜0.05).There were no statistically significant differences before and after anesthesia of 15 min between the two groups (P ＞0.05).After anesthesia of 30,45,60 min and at the end of operation,the temperature in the observation group were higher than those of control group,with statistically significant differences (P ＜ 0.05).There were no statistically significant differences of prothrombin time,activated partial thrombin time and fibrinogen in the observation group (P ＞ 0.05),but the indicators above in the control group after the operation were higher than those of before operation,with statisti cally significant differences (P ＜ 0.05).The incidences of hypothermia,shiver and cystospasm in the observation group were lower than those of control group,with statistically significant differences (P ＜ 0.05).Conclusion The application of inflatable warming blanket during TURP has a good body temperature protection effect,which can avoid the coagulation dysfunction caused by hypothermia.%目的 探讨经尿道前列腺切除术(TURP)中使用充气加温毯的体温保护效果及其对患者凝血功能的影响.方法 选择2016年2月～2017年7月在长海医院拟行TURP治疗的良性前列腺增生患者126例,按随机数字表分为对照组和观察组,每组各63例.两组均行TURP治疗,对照组围术期给予常规综合体温干预,观察组在对照组基础上给予充气加温毯进行体温保护,比较两组围术期体温,术前、术后凝血功能及并发症发生情况.结果 单因素方差分析显示,两组麻醉前及麻醉后各时间点体温比较,差异有统计学意义(F=46.24、92.86,P＜ 0.05).麻醉前及麻醉后15 min两组体温比较,差异均无统计学意义(P＞0.05).观察组麻醉后30、45、60 min及手术结束时体温均高于对照组,差异均有统计学意义(P＜ 0.05).观察组术前及术后凝血酶原时间、活化部分凝血活酶时间和纤维蛋白原比较,差异均无统计学意义(P＞0.05),对照组术后上述各项指标均高于术前,差异均有统计学意义(P＜0.05).观察组低体温、寒战、膀胱痉挛发生率均明显低于对照组,差异有统计学意义(P＜0.05).结论 TURP术中使用充气加温毯可起到良好的体温保护效果,可以避免由于低体温导致的凝血功能障碍.