| Objective:To explore the effects of different comprehensive insulation measures on the intraoperative body temperature,homeostasis and postoperative recovery of patients undergoing laparotomy,so as to screen the best perioperative comprehensive insulation method for patients undergoing laparotomy and provide reference for the clinical application of this method.Methods: A total of 128 patients who received elective open surgery in a Grade-A hospital in Xinjiang from January to December 2022 were randomly divided into 4 groups.Group A adopts pre-insulation + quilt cover heating;Group B adopts pre-insulation + quilt covering + inflatable thermal insulation blanket heating;Group C uses pre-insulation + quilt covering + electric blanket heating;Group D was treated with pre-insulation + quilt covering + transfusion and blood heating.The nasopharyngeal temperature of the subjects was compared at 8 time points from entry(T0)to the end of surgery(T7).Whether there were differences in homeostasis indexes before anesthesia induction(T1),180 min after anesthesia induction(T5)and at the end of surgery(T7),as well as postoperative recovery(including inflammation,intestinal function recovery,postoperative recovery quality score,complications,postoperative drainage length and postoperative hospital stay).Results: 1)General clinical data: there were no statistical differences among different groups in age,gender,BMI,ASA grading,intraoperative infusion volume,blood transfusion volume,blood loss,urine volume,operation duration,anesthesia duration,and postoperative destination(P > 0.05);2)nasopharyngeal temperature: there was no difference in nasopharyngeal temperature between group B and group C,and it was higher than that between groups A and D(P<0.001).The incidence of hypothermia was 53.1% in group A,3.1% in group B,6.5% in group C,and 34.4% in group D.There were statistical differences in the incidence of hypothermia among all groups(P<0.05).3)Intraoperative homeostasis: The changing trend of homeostasis indexes of the subjects was the same over time,and the change range of homeostasis indexes in groups B and C was less than that in groups A and D,that is,the homeostasis in groups B and C was stable(P< 0.05).4)IInflammatory response:C-reactive protein(CRP),interleukin 6(IL-6),procalcitonin(PCT),leukocyte(WBC)and neutrophil(N)were all increased to varying degrees 1 day after surgery compared with 1day before surgery(P<0.001).The levels of C-reactive protein(CRP),leukocyte(WBC)and neutrophil(N)in different groups were different(P<0.05).The rise of group B and C was smaller than that of group A and D;5)Recovery of intestinal function: there were differences in recovery of intestinal function among all groups(P < 0.05).The gastrointestinal function of group B was the best;6)Postoperative recovery quality score:patients in different comprehensive insulation groups had differences in postoperative comfort and pain scores(P<0.001),group B and group C had higher comfort scores,but lower pain scores than other groups;7)Other postoperative recovery conditions: In terms of postoperative complications,postoperative drainage retention time and postoperative hospitalization days,groups B and C were lower than groups A and D(P<0.05).Conclusion: By comparing the thermal insulation effect of different comprehensive thermal insulation groups,group B(pre-thermal insulation + quilt covering + inflatable thermal insulation blanket heating)and group C(pre-thermal insulation + quilt covering +electric blanket heating)had the best thermal insulation effect during laparotomy,and effectively maintained intraoperative homeostasis,reduced postoperative inflammatory response of patients,promoted the recovery of intestinal function,reduced postoperative discomfort of patients,and reduced the length of hospital stay.Promote postoperative recovery of patients. |
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