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| 闭环体温管理对腹腔镜手术患儿术中体温的影响 |
| Effect of closed-loop temperature management on intraoperative body temperature in pediatric patients undergoing laparoscopic surgery |
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| DOI：10.12089/jca.2025.08.003 |
| 中文关键词: 物联网 围麻醉期 体温管理 儿童 腹腔镜手术 |
| 英文关键词: Internet of things Peri-anesthesia period Temperature management Child Laparoscopic surgery |
| 基金项目:杭州市生物医药和健康产业发展扶持科技专项（2022WJC075） |
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| 中文摘要: |
目的： 探讨闭环体温管理在围麻醉期患儿腹腔镜手术体温管理中应用的有效性。
方法：选择择期行腹腔镜手术的患儿120例，男54例，女66例，年龄1~3岁，ASAⅠ或Ⅱ级。采用随机数字表法将患儿分为两组：闭环体温管理组（CL组）和常规保温组（C组），每组60例。CL组引入全程闭环体温管理系统，C组术中采用棉被保温。记录佩戴体温传感器8 min、麻醉诱导时、诱导后10、30和 60 min、术毕时、入PACU时体温，术前1 d和术毕时凝血酶时间（TT）、凝血酶原时间（PT）、活化部分凝血酶时间（APTT）。记录术中低体温、术后寒战、手术部位感染（SSI）发生情况、拔管时间和术后住院时间。
结果：与佩戴体温传感器8 min时比较，C组诱导后30、60 min、术毕时、入PACU时体温明显降低（P＜0.05）。与C组比较，CL组麻醉诱导时、诱导后60 min、术毕时、入PACU时体温明显升高（P<0.05）。与麻醉诱导时比较，C组术毕时TT、PT、ATPP明显延长（P<0.05）。与C组比较，CL组术毕时TT、PT、ATPP明显缩短（P<0.05），术中低体温、术后寒战发生率明显降低（P<0.05），拔管时间明显缩短（P<0.05）。两组SSI发生率和术后住院时间差异无统计学意义。
结论：闭环体温管理系统在围麻醉期患儿腹腔镜手术体温管理中可有效降低低体温发生率、改善凝血功能、减少术后寒战、缩短拔管时间，值得临床推广应用。 |
| 英文摘要: |
Objective: To investigate the effectiveness of closed-loop temperature management in peri-anesthesia body temperature control in pediatric patients undergoing laparoscopic surgery.
Methods: A total of 120 pediatric patients scheduled for elective laparoscopic surgery were enrolled, including 54 males and 66 females, aged 1 to 3 years, ASA physical status Ⅰ or Ⅱ. Children were assigned to two groups using a random number table: closed-loop temperature management group (group CL) and conventional warming group (group C), 60 children in each group. Group CL received closed-loop temperature management throughout the procedure, while group C received conventional warming with a cotton quilt during surgery. Body temperature at 8 minutes after wearing the temperature sensor, at induction of anesthesia, 10, 30, and 60 minutes after induction, at the end of surgery, and upon entering to the PACU were recorded. Thrombin time (TT), prothrombin time (PT), and activated partial thromboplastin time (APTT) were measured one day before surgery and at the end of surgery. The incidence of intraoperative hypothermia, postoperative shivering, postoperative surgical site infection (SSI), extubation time, and postoperative hospital stay were also recorded.
Results: Compared with 8 minutes after wearing the temperature sensor, the body temperature in group C was significantly lower at the time of 30 and 60 minutes after induction, the end of surgery, and upon entering to the PACU (P < 0.05). Compared with group C, the body temperature in group CL was significantly higher at the time of induction of anesthesia, 60 minutes after induction, the end of surgery, and upon entry to the PACU (P < 0.05). Compared with the time of anesthesia induction, TT, PT, and ATPP in group C were significantly prolonged at the end of the operation (P < 0.05). Compared with group C, TT, PT, and ATPP in group CL were significantly shortened at the end of the operation (P < 0.05), the incidence of intraoperative hypothermia and postoperative shivering was significantly reduced (P < 0.05), and the extubation time was significantly shortened (P < 0.05). There were no significantly differences in the incidence of SSI and postoperative hospital stay time between the two groups.
Conclusion: Closed-loop temperature management system can effectively reduce the incidence of hypothermia, improve coagulation function, reduce postoperative shivering, and shorten extubation time in pediatric patients undergoing laparoscopic surgery during the peri-anesthesia period, which is worthy of clinical application and promotion. |
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