手术中体温控制对腰椎手术出血量的影响

Effect of body temperature control on intraoperative blood loss in lumbar surgery

摘要:

[目的] 探讨手术中体温控制对腰椎手术患者术中出血量的影响。[方法] PLIF 手术的80 例患者采用随机数字表法将其划分为两组：常规组40 例，给予术中常规保温，控温组40 例，给予术中动态体温控制。观察记录两组患者围手术期核心体温以及术中出血量。[结果] 两组患者均顺利手术，均无严重并发症。控温组患者术中全部维持正常体温，常规组患者24/40（60%） 术中出现体温过低。常规组的术中出血量显著高于控温组[(355.3±86.4) ml vs (230.3±49.2) ml, P＜0.001]。Pearson 相关分析表明，术中1 h（r=-0.837, P＜0.001） 和麻醉复苏后（r=-0.839, P＜0.001） 核心体温与术中出血量呈显著负相关。[结论] 手术体温控制可以避免腰椎手术患者术中低体温的发生，减少术中出血量，同时减少输血需求。

Abstract:

[Objective] To investigate the effect of body temperature control on intraoperative blood loss in lumbar surgery. [Methods]A total of 80 patients undergoing posterior lumbar interbody fusion (PLIF) were divided into two groups by random number table method. Ofthem, 40 patients in the routine group (RG) received conventional intraoperative body temperature management, while other 40 patients inthe temperature control group (TCG) underwent intraoperative dynamic temperature control. Perioperative core body temperature and intra-operative blood loss were observed and recorded. [Results] All patients in both groups were operated successfully without serious complica-tions. All patients in the TCG maintained normal body temperature during operation, instead, 24/40 (60%) patients in the RG experiencedhypothermia during operation. The RG got significantly greater intraoperative blood loss than the TCG [(355.3±86.4) ml vs (230.3±49.2) ml,P＜0.001]. As result of Pearson correlation, the core body temperature was significantly negatively correlated to intraoperative blood loss 1hour intraoperatively (r= -0.837, P＜0.001) and after anesthesia resuscitation (r=-0.839, P＜0.001). [Conclusion] Body temperature controlcan avoid the occurrence of intraoperative hypothermia in lumbar surgery, reduce the amount of intraoperative blood loss, and reduce theneed for blood transfusion.