The Protective Effects Of Thermal Insulation Technology For Patients Undergoing Renal Transplantation

Background: The transplanted renal function is affected by many factors. Preservation of renal allograft need ice pack to reduce the metabolic rate and oxygen consumption of the Organization, more prone to intraoperative hypothermia. Constant temperature environment is the essential conditions for normal body metabolism. In recent years, with improved monitoring techniques, more attention of the patients in the low-temperature measures against the application of thermal insulation. Studies have shown that: 60% of the patients in the entire operation have occurred in the course of hypothermia. The lower body temperature will affect the functions of circulatory, respiratory and nervous system. Such as the effects, anesthesia recovery period is extended, wound infection rate of increase, chills increase in the incidence of complications. Objective: This study was to compare the spinal anesthesia-epidural anesthesia under the kidney transplantation surgery at room temperature and insulation measures for the patients vital signs and physiological indicators of the impact of these two methods in the evaluation the effect of insulation technology used in the process of clinical value, in order to increase patient safety during and after exploration and improve the prognosis. Methods: Experiments are divided into room temperature groups and insulation normothermia group. Insulation Group: operating table surface foreshadow heated blanket, the temperature is set to 38℃, of the patients in the continuous heating. The infusion and blood temperature maintained to 37℃. At room temperature groups: during surgery, do not impose any interventions. Monitoring indicators: 1,Subjects age, sex, height, weight. 2,Center temperature, skin temperature. 3,Mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP). 4,Blood gas. 5,Preoperative one day after seventh day aspartate amino-transferase (AST), alanine amino- transferase (ALT), albumin(Alb). 6,Preoperative day and after day, third day, seventh day of a serum creatinine (SCr), blood urea nitrogen (BUN). 7,Anesthesia before surgery, the operation began and after one hour, arteriovenous open, the end of operation, 24-hour surgery ended serum cortisol changes. And the infusion volume, duration of surgery, chills, wound infection, hospitalization time. Results: 1,Two groups were generally no difference. 2,Patients in the room temperature group the skin temperature lower, and thermal insulation group of the skin temperature is higher than that of room temperature group, but between the two groups no significant difference. 3,With the surgery, the centre temperature decreased gradually in patients of room temperature group and the low-temperature state occurred when surgery procedure to 90min, while patients of Insulation Group the temperature in the centre without significant changes. 4,The two groups of patients with MAP, HR and CVP no significant difference. 5,In three time points to measure arterial blood gas, the PH value at room temperature group was significantly lower than the control value. At the time point of transplanted kidney AV open, PH value of 7.32, PH value for the end of operation 7.31, the difference was significant, P<0.05. PH value of insulation group was in the normal range. The difference between the two groups significantly, P<0.05. 6,AST, ALT and albumin in the seventh day decreased in varying degrees compared with the preoperative, significantly, P<0.05. There was no significant difference compared between the two groups. 7,SCr, BUN of two groups in the perioperative compared with the preoperative have varying degrees of decline, the difference was significant, P<0.05. At the same time, the levels SCr and BUN of insulation group dropped more compared with the room temperature group, obvious difference between the two groups significantly, P<0.05. 8,Serum cortisol at room temperature surgery patients began to increase continued until after 24 hours. Serum cortisol of insulation group increased during surgery, at the end of operation, down to the level of anesthesia before. There was notable difference between the two groups, P<0.05. 9,In the other arts, postoperative complications such as chills, wound infection and hospitalization time between the two groups showed no statistical difference. Conclusion: The application of variable heated blankets and heating to maintain blood transfusion patients with renal transplantation center temperature in the normal range, help patients with heart rate, mean arterial pressure, central venous pressure balance will help reduce the occurrence of acidosis; help in the function of the new transplanted kidney SCr, BUN decreased rapidly at the same time to reduce the body's stress response.