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| 鼓膜温度与食管下段温度在老年患者全膝关节置换术中的一致性分析 |
| Consistency analysis between tympanic temperature and lower esophageal temperature in elderly patients undergoing total knee arthroplasty |
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| DOI：10.12089/jca.2025.01.011 |
| 中文关键词: 鼓膜温度 食管下段温度 喉罩 全身麻醉 低体温 一致性 |
| 英文关键词: Tympanic temperature Lower esophageal temperature Laryngeal mask General anesthesia Hypothermia Consistency |
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| 中文摘要: |
目的：分析全麻下行全膝关节置换术（TKA）患者术中鼓膜温度与食管下段温度的一致性，并探讨鼓膜温度传感器（HPT105）的准确性。
方法：选择择期喉罩全麻下行TKA的老年患者81例，男35例，女46例，年龄65～80岁，BMI 18.5～30.0 kg/m2，ASA Ⅱ或Ⅲ级。患者入室后行鼓膜温度监测，麻醉诱导后置入喉罩，以胃管吸引胃液后拔除胃管，放置食管温度探头至食管下段1/3处，显示温度平稳后记录此时鼓膜温度及食管温度，并记录麻醉后30、60 min、松止血带前、松止血带后15 min及拔除喉罩前鼓膜温度及食管下段温度。记录术后进入PACU和转出PACU时鼓膜温度。采用Bland-Altman一致性分析、Spearman相关分析探索鼓膜温度与食管下段温度的相关性、一致性及差异。
结果：两种不同监测方法在不同时点监测的体温差异无统计学意义。鼓膜温度与食管下段温度具有高度一致性，Bland-Altman的偏倚为（0.12±0.14）℃，95%可信区间（CI）为（-0.15～0.38）℃；Spearman相关系数（r）=0.96（P＜0.001）。
结论：全膝关节置换术中老年患者的鼓膜温度与食管下段温度高度一致，鼓膜温度传感器对于核心体温监测具有准确性和可靠性，可实现高风险低体温患者围术期的全程监测。 |
| 英文摘要: |
Objective: To analyse consistency between tympanic temperature and the lower esophageal temperature in elderly patients undergoing total knee arthroplasty under general anesthesia with laryngeal mask airway, and to investigate the accuracy of tympanic temperature sensor (HPT105) used for continuous intraoperative monitoring.
Methods: Eighty-one elderly patients with TKA under general anesthesia were selected, including 35 males and 46 females, aged 65-80 years, BMI 18.5-30.0 kg/m2, and ASA physical status Ⅱ or Ⅲ. The tympanic temperature of all patients were monitored after entering the room. After general anesthesia induction, laryngeal mask was inserted. Gastric fluid was attracted by gastric tube, and then the gastric tube was removed, and the esophageal temperature probe was placed to the lower 1/3 of the esophagus. Tympanic temperature and esophageal temperature were recorded when the temperature was stable. The temperature was recorded 30, 60 minutes after anesthesia, before tourniquet removal, 15 minutes after tourniquet removal, and before laryngeal mask removal. Tympanic temperature in and out of PACU after operation were recorded. Bland-Altman consistency analysis and Spearman correlation analysis were used to detect the correlation, consistency and difference between the tympanic temperature monitoring data and the lower esophageal temperature monitoring data.
Results: There was no statistically significant difference in body temperature between the two different monitoring methods at different time points. The tympanic temperature was consistency with the lower esophageal temperature. Bland-Altman bias was (0.12 ± 0.14) ℃, 95% confidence interval (CI) was (-0.15 to 0.38), and Spearman's rank correlation coeffcient (r) was 0.96 (P < 0.001).
Conclusion: The tympanic temperature is consistency with the lower esophageal temperature in elderly patients undergoing total knee arthroplasty, tympanic temperature sensor has high accuracy and reliability for monitoring core body temperature, and can realize the whole process monitoring of perioperative high-risk patients with hypothermia. |
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