| Hypothermia are common complications of general anesthesia in perioperative. The reason for this general anesthesia and muscle relaxants vascular heat loss, as a result of low-temperature, infusing in the operating room a lot colder liquid, large areas of central narcotics suppression of body temperature, physical skin exposed, a large number of peritoneal washing and other factors, and carbon dioxide (CO2) pneumoperitoneum-related. Before the starting of the operation of 30m in, due to the redistribution of body heat, heat transfering to peripheral body Center, large temperature difference between in vivo and peripheral, transfer quickly, as the core temperature is significantly lower, which led to a series of pathophysiological changes. Compared with the traditional open surgery during perioperative period in patients with laparoscopic surgery also caused drop in body temperature, also affect the patients waking up and extubation time in postoperative. Therefore patients undergoing laparoscopic colorectal surgery for efficient temperature monitoring and protection is to ensure that safety management measures in patients. By observing the implementation of warming measures on core temperature and changes of blood glucose, lactic acid, evaluating the effects of changes of core body temperature on blood glucose, blood lactate.Objective:This experiment through observating the of core patient temperature in general anesthesia, blood glucose, blood lactate, extubation and recovery time, evaluating the effect of warming on laparoscopic surgery for colorectal cancer. To examine how a safe, effective treatment and preventive measures to ensure thebody temperature constant of patients dming perioperation Surgical trauma, blood dilution due to anaesthesia, hypothermia, and other factors often stimulate the body, leading to significant releasing of stress hormones, insulin relative shortage, high blood glucose Is the earlier manifestations of stress reaction of blood glucose, lactic acid is specific metabolites in anaerobic glycolysis, changes of blood lactic acid in the perioperative period reflect the body's glucose metabolism, peripheral circulation and tissue perfusion and oxygenation status. So lactate accumulation as hypoxia, poor perfusion of outcome measures.Method:Select our laparoscopic treatment of 40 cases of patients with colorectal, male 23 and female 17 cases,34-78 years old, body weight 46-78kg, ASA gradeⅡ-Ⅲlevel, basic normal temperature, lung, liver and kidney function, is expected to more than 2 hours operation time, transfusion is greater than the 2000 ml. Dysfunction of blood coagulation and the recent history of fever or infection, hyperthyroidism or hypothyroidism was excluded. Patients and randomly divided into control group warming group, each group of 20 cases, two groups of patients in General was not statistically significant differences. A control operation at room temperature (22-24℃) and humidity (40%-60%) is conducted without any insulation measures, transporting liquid and rinse are at room temperature. T Group at room temperature the same control for the experimental group (22 (?)-24(?)), limbs, chest, cover blankets, transporting liquid and rinse the use of infusion warming box (United States Mallinckrodt Medical products) heated to 37℃. Two groups of patients before anesthesia of core body temperature and comparison between groups within the group are not statistically (P>0.05). From anesthesia Hou changes trend view, t group in monitoring of the time points core temperature changes more smooth, group core temperature in T4, and T5, and T6, and T7 time points decline obvious (P<0.01),-a group T3 and T1 comparison (P<0.01), t group T3 and Tl comparison (P<0.01). by table 2 visible two group in T4-T7 time points of core temperature of differences are has statistics significance (P<0.01), from changes trend view, t group in the time points of nasopharyngeal temperature changes more smooth, and-a group of core temperature decline obvious. by table 3 visible two group patients house of blood glucose (Glu) group within and the group between comparison differences no statistics significance (P>0.05), Wai operation period L6, and L7 obvious rise, operation completed still is not recovery normal level. L6, L7 and t group a comparison group (P<0.01). table 42 group house of blood lactic acid in (Lac) and the difference was not statistically compared between groups within the group (P>0.05), L6, L7, the two groups is significantly higher than before the anesthesia. L6, L7 and t group a comparison group (P<0.01). Can be seen from table 5, compared with a group, group t time of Extubation in patients with significantly reduced (P<0.01) corresponding waking up significantly ahead of time.Results:In patients with General comparison:two groups of patients with gender, age, weight, ASA Circumstances such as grading, surgery, anesthesia time difference was not statistically significant (P>0.05)。Observation two grouppatients in anesthesia Qian(T1), induced Hou30 min (T2), and60 min (T3), and90 min (T4), and 120min (T5), and 150 min(T6), operation completed(T7) time points of core temperature. Observation onT1, andT2, andT3, andT4, andT5, andT6and theT7patients with blood glucose, blood lactate changes. Two groups of patients before anesthesia of core body temperature and comparison between groups within the group are not statistically (p>0.05). From anesthesia Hou changes trend view,tgroup in monitoring of the time points core temperature changes more smooth,-a group core temperature inT4, andT5, andT6, and T7 time points decline obvious (p <0.01),-agroupT3 and T1 comparison(p<0.01), tgroup T3 and T1 comparison(p <0.01). By table2visible two group inT4-T7time points of core temperature of differences are has statistics significance(p<0.01), from changes trend view, t Group in the time points of nasopharyngeal temperature changes more smooth, and-a Group of core temperature decline obvious. Table3visibleHouse of blood glucose in patients with the two groups (Glu) comparison between group and group difference was not statistically significant (p>0.05), peri-L6, and L7 significantly increased, is still not back to normal levels. Tgroup L6, and L7 and comparison group (p<0.01). Table4House of blood lactic acid in the two groups (Lac) comparison between group and group difference was not statistically significant (p>0.05), two groups inL6, andL7significantly higher than before the anesthesia. TgroupL6, andL7andcomparison group (p<0.01). Table5shows thatcompared to the group,t-set time of Extubation in patients with significantly reduced (p<0.01)corresponding waking up significantly ahead of time.Conclusion:Intraoperative hypothermia is not only the General temperature imbalances in traditional surgery, also exists in laparoscopic surgery. Temperature is one of the important human vital signs, body temperature constant is to maintain the normal physiological function For the maintenance of perioperative body temperature, in terms of perioperative management of, or from a postoperative recovery in patients with clinical treatment, extent, prevention is better than cure. Under anesthesia and operation status, the body can produce a stress response:disorders of metabolism, catabolism enhancement, characterized by elevated blood glucose, lactate. Peri-operative period for patients taking blood transfusion, infusion and fluid temperature adjustment, room temperature insulation measures such as regulation, significantly reducing incidence of drop in body temperature and low temperature, reducing anesthesia and surgical effect of stress on the body caused by metabolism, avoiding patients into the vicious circle of hypothermia, acidosis, and dramatically shorten the time of awake, and extubation. |
