双管加温二氧化碳吹雾管改善非体外循环冠状动脉旁路移植术患者术中低体温的效果

Effect of two-pipe heating CO2 moister blower in improving intraoperative hypothermia in patients undergoing off-pump coronary artery bypasses grafting

  • 摘要:
      目的  观察双管加温二氧化碳(CO2)吹雾管对非体外循环冠状动脉旁路移植术(OPCAB)患者术中低体温的改善效果。
      方法  选取30例OPCAB患者作为研究对象,采用随机数字表法分为对照组与观察组,每组15例。对照组使用液体管路为37℃生理盐水、气体管路未加温的CO2吹雾管进行吹雾驱血;观察组使用双管加热的CO2吹雾管进行吹雾驱血。观察并比较2组气雾温度、心率变异率、核心体温情况。
      结果  观察组接管后2.5 min、吹雾30.0 min时的气雾温度均高于对照组,差异有统计学意义(P < 0.05);与接管后2.5 min相比,对照组吹雾30.0 min时的气雾温度大幅降低,差异有统计学意义(P < 0.05);观察组接管后2.5 min、吹雾30.0 min时的气雾温度比较,差异无统计学意义(P>0.05)。开心包时、吹雾3.0 min时、关心包时、出室前,观察组核心体温合格率均高于对照组,差异有统计学意义(P < 0.05)。吹雾3.0、10.0、20.0、30.0 min时,观察组的心率变异率均低于对照组,差异有统计学意义(P < 0.05)。
      结论  OPCAB患者术中使用双管加热的CO2吹雾管后,气雾温暖且恒定,低体温情况得到改善,心率变异率较低,能够有效防止手术导致的低体温现象。

     

    Abstract:
      Objective  To observe effect of two-pipe heating CO2 moister blower in improving intraoperative hypothermia in patients undergoing off-pump coronary artery bypasses grafting (OPCAB).
      Methods  Thirty OPCAB patients were selected as research objects and divided into control group and observation group by random number table method, with 15 cases in each group. In the control group, CO2 moister unheated blower with a liquid pipe of 37℃ normal saline was used to expel blood, while the observation group was used the two-pipe heating CO2 mister blower to expel blood. A comparative analysis was made over the aerosol temperature, heart rate variability, and core temperature of the two groups.
      Results  The aerosol temperature of the observation group was higher than that of the control group at 2.5 min after takeover and 30.0 min after moist blowing (P < 0.05). Compared with 2.5 min after takeover, the aerosol temperature in the control group decreased significantly when blowing fog for 30.0 min(P < 0.05). There was no significant difference in the aerosol temperature of the observation group at 2.5 min after takeover and 30.0 min after blowing fog (P>0.05). The qualified rates of core body temperature in the observation group were higher than that in the control group at the time points of opening pericardium, blowing fog for 3.0 min, closing pericardium and before leaving the room (P < 0.05). The heart rate variabilities of the observation group were lower in the observation group than those of the control group at 3 minutes, 10 minutes, 20 minutes and 30 minutes after moist blowing (P < 0.05).
      Conclusion  Aerial fog is warm and constant after application of two-pipe heating CO2 moister blower in OPCAB patients during surgery, and hypothermia of patients is improved and the heart rate variability is relatively low, which can effectively prevent the hypothermia caused by OPCAB surgery.

     

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