婴幼儿体外循环手术中体温干预对快通道的影响

摘要

Objective To study the clinical effect of nursing intervention of body temperature in the fast track anesthesia during the CPB (cardiopulmonary bypass).Methods 318 infants of adopting the CPB from April 2015 to June 2016 in our hospital were selected.The subjects were randomly divided into two groups,159 cases each group.The intervention group adopted the nursing intervention of body temperature;the control group did not adopt the nursing intervention of body temperature.The coagulation function at different time periods for two groups was observed.After surgery,the extubation time was analyzed.Results There was no significant difference in the levels of PT,APTT and TT between the two groups after the induction of anesthesia (P>0.05);There were significant differences in PT,APTT and TT levels in the intervention group and the control group after the end of operation (P<0.05);after surgery,the average extubation time for intervention group and control group was (31.2±8.9)min and (43.2±10.2)min (P<0.05).Conclusion The nursing intervention of body temperature can maintain the patient's coagulation function during the CPB,reduce the postoperative bleeding volume,promote the infant's fast recovery and improve the prognosis.It is worthy of clinical application and promotion.%目的 研究体温干预在婴幼儿体外循环手术中对快通道的影响.方法 临床纳入318例我院2015年4月至2016年6月期间行体外循环手术(CPB)的患儿作为研究对象.根据随机数字表法分为两组各159例.其中159例患儿术中采用体温干预作为干预组,另159例患儿术中未实施体温干预作为对照组.观察两组患儿不同时段凝血功能变化情况,分析患儿手术结束至复苏后拔管时间.结果 麻醉诱导后两组患儿PT、APTT以及TT水平对比差异无统计学意义,P>0.05;应用肝素时以及手术结束后干预组患儿PT、APTT以及TT水平与对照组相比差异有统计学意义,P<0.05.干预组患儿手术结束至复苏后拔管时间平均为(31.2±8.9)min,小于对照组的(43.2±10.2)min,P<0.05.结论 体温干预可有效维持体外循环手术患儿凝血功能,减少术后出血情况,促进患儿苏醒和预后效果,值得临床应用及推广.