“4+3”暖链式动态体温管理联合亲人语言唤醒对胸腔镜肺手术患者的影响

张天天; 陈叡喆; 鲍映雪

doi:10.16766/j.cnki.issn.1674-4152.003956

“4+3”暖链式动态体温管理联合亲人语言唤醒对胸腔镜肺手术患者的影响

doi: 10.16766/j.cnki.issn.1674-4152.003956

1.
温州医科大学附属第一医院手术室，浙江温州 325000
2.
浙江省人民医院手术室，浙江杭州 314408

基金项目:

温州医科大学附属第一医院计划项目 HLKY202204

浙江省医药卫生科技计划项目 2022KY496

详细信息

通讯作者:
陈叡喆，E-mail：359538318@qq.com

中图分类号: R655.3 R472.3
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出版历程
- 收稿日期: 2024-09-28
- 网络出版日期: 2025-06-30

Effect of "4 + 3" warm chain dynamic body temperature management combined with family language awakening on patients undergoing thoracoscopic lung surgery

1.
Operating Room, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的探讨“4+3”暖链式动态体温管理联合亲人语言唤醒对全麻下胸腔镜肺手术患者的影响，为临床构建更完善的围手术期处理方案提供参考。方法选取2023年1月—2024年1月于温州医科大学附属第一医院择期开展全麻下胸腔镜肺手术的患者109例，采用随机数表法分为对照组(55例)和观察组(54例)。对照组采取手术室常规保温措施和医务人员唤醒，观察组采用“4+3”暖链式动态体温管理联合亲人语言唤醒，比较2组不同时间点体温、麻醉苏醒情况及不良反应发生率。结果观察组麻醉诱导时(T1)、麻醉诱导后15 min(T2)、手术30 min(T3)、手术60 min(T4)、手术90 min(T5)、术毕(T6)及入复苏室10 min(T7)体温均高于对照组(P＜0.05)；观察组自主意识恢复时间为(15.88±3.24)min，自主呼吸时间为(6.44±2.10)min，复苏室滞留时间为(21.24±4.13)min，均低于对照组的(22.56±2.78)min、(9.34±2.45)min和(31.90±4.55)min(P＜0.05)；观察组不良反应发生率为5.56%(3/54)，低于对照组的18.18%(10/55，P＜0.05)。结论给予全麻下胸腔镜肺手术患者“4+3”暖链式动态体温管理联合亲人语言唤醒干预，可维持患者围手术期体温稳定，促进麻醉苏醒，缩短复苏室滞留时间，降低不良反应发生率。
- 胸腔镜肺叶切除术 /
- 体温管理 /
- 语言唤醒 /
- 低体温 /
- 麻醉苏醒时间
Abstract: Objective To explore the effect of "4+3" warm chain dynamic body temperature management combined with relatives' language awakening on thoracoscopic lung surgery patients under general anesthesia, and to provide a reference for clinical construction of a more perfect perioperative intervention plan. Methods From January 2023 to January 2024, 109 patients undergoing thoracoscopic lung surgery under general anesthesia in the First Affiliated Hospital of Wenzhou Medical University were selected and divided into control group and experimental group by random number table method, with 55 and 54 cases respectively. The control group took routine insulation measures in the operating room and woke up by medical staff, and the observation group used "4+3" warm chain dynamic body temperature management combined with relatives ' language to wake up. The temperature, anesthesia recovery, and incidence of adverse reactions of the two groups were compared at different time points. Results The body temperature of experimental groups at anesthesia induction (T1), 15 min after anesthesia induction (T2), 30 min after surgery (T3), 60 min after surgery (T4), 90 min after surgery (T5), after surgery (T6) and 10 min after entering anesthesia recovery room (T7) were all higher than those of the control group (P < 0.05). The recovery time of spontaneous consciousness was (15.88±3.24) min, the spontaneous breathing time was (6.44±2.10) min, and the retention time in the anesthesia recovery room was (21.24±4.13) min, which were lower than that of the control group [(22.56±2.78) min, (9.34±2.45) min, and (31.90±4.55) min (P < 0.05)], and the incidence of adverse reactions was 5.56% (3/54), which was lower than that of the control group [(18.18% (10/55), P < 0.05]. Conclusion The "4+3" warm chain dynamic body temperature management combined with relatives' language awakening intervention can maintain the perioperative temperature stability of patients with thoracoscopic lung surgery under general anesthesia, promote anesthesia recovery, shorten the retention time in the resuscitation room, and reduce the incidence of adverse reactions.
- Thoracoscopic lobectomy /
- Body temperature management /
- Language awake /
- Hypothermia /
- Anesthesia recovery time

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表 1 2组全麻下胸腔镜肺手术患者基线资料比较

Table 1. Comparison of baseline data between two patient groups of undergoing thoracoscopic lung surgery with general anesthesia

组别	例数	性别(男性/女性，例)	年龄(x±s，岁)	BMI(x±s，岁)	麻醉分级(Ⅰ/Ⅱ级, 例)	手术时间(x±s，min)	出血量(x±s，mL)	输液量(x±s，mL)
对照组	55	25/30	58.18±6.77	23.09±2.11	31/24	95.53±10.11	60.98±7.88	1 423.88±20.77
观察组	54	21/33	58.15±8.41	23.17±3.09	28/26	94.84±9.16	61.29±9.23	1 417.09±25.43
统计量		0.482^a	0.021^b	0.158^b	0.223^a	0.157^b	0.189^b	1.753^b
P值		0.488	0.984	0.875	0.636	0.876	0.851	0.083
注：^a为χ²值，^b为t值。

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表 2 2组全麻下胸腔镜肺手术患者各时点体温比较(x±s，℃)

Table 2. Comparison of body temperature at different time points between two patient groups undergoing thoracoscopic lung surgery with general anesthesia (x±s, ℃)

组别	例数	T0	T1	T2	T3	T4	T5	T6	T7	F值	P值
对照组	55	36.57±0.34	36.40±0.45	36.29±0.24	36.14±0.28	36.08±0.36	36.01±0.28	36.11±0.31	36.25±0.46	33.451	＜0.001
观察组	54	36.56±0.41	36.52±0.23	36.50±0.33	36.47±0.27	36.43±0.29	36.40±0.33	36.45±0.37	36.50±0.31	89.091	＜0.001
F值		0.083	20.091	56.781	67.891	88.091	100.121	134.190	156.230
P值		0.771	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001

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表 3 2组全麻下胸腔镜肺手术患者麻醉苏醒质量比较(x±s，min)

Table 3. Comparison of anesthesia and recovery quality between two groups undergoing thoracoscopic lung surgery with general anesthesia (x±s, min)

组别	例数	自主意识恢复时间	自主呼吸时间	复苏室滞留时间
对照组	55	22.56±2.78	9.34±2.45	31.90±4.55
观察组	54	15.88±3.24	6.44±2.10	21.24±4.13
t值		11.559	6.630	12.801
P值		＜0.001	＜0.001	＜0.001

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表 4 2组全麻下胸腔镜肺手术患者不良反应发生率比较[例(%)]

Table 4. Comparison of adverse reaction incidence between two groups undergoing thoracoscopic lung surgery with general anesthesia [cases (%)]

组别	例数	低体温	寒战	躁动	麻醉苏醒延迟	总计
对照组	55	5(9.09)	1(1.82)	1(1.82)	3(5.45)	10(18.18)
观察组	54	1(1.85)	0	0	2(3.70)	3(5.56)
χ²值		1.530			< 0.001	4.135
P值		0.216	0.993^a	0.993^a	0.983	0.042
注：^a为采用Fisher精确检验。

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