| The constant temperature is the fundamental guarantee for the body to maintain the physiological activities.Children's ability to regulate the temperature have not developed yet perfectly,and the volume of surface area ratio is small as well as the lack of reflection for the children.These unique physiological characteristics determine that the body temperature in the perioperative period is more abnormal than that of the adults,and the hypothermia is more common.The upper and lower fluctuations in body temperature,especially the low temperature,will bring many adverse consequences to the children.There,to maintain the children's temperature has to be immediate reacting to these adverse consequence.In recent years,laparoscopic technology has been developing rapidly.It is widely used in pediatric surgery because of its advantages such as less operative trauma,clearer field,less pain and faster recovery,less wound and no effect on appearance.The patients require a carbon dioxide pneumoperitoneum and a special position during laparoscopic surgery which leads to greater physiological changes to the children.The effect of body temperature protection on the end tidal carbon dioxide partial pressure of children during laparoscopic hernia repair is discussed.Collected in our hospital from March 2016 to December 2016 undergoing laparoscopic hernia repair in 60 cases,age: 1~5,weight: 7kg ~ 25 kg,ASA I or II,there were 48 males and 12 females.They were randomly divided into experimental group(E)and control group(C),with 30 cases in each group.The two groups were performed by the same group.In the experimental group,the heat preservation blanket was used in the operation and the control group was operated at the normal room temperature.The other conditions were the same.We recorded the time of admission(T0),5 minutes before pneumoperitoneum(T1),5minutes after pneumoperitoneum(T2),10 minutes after pneumoperitoneum(T3),20 minutes after pneumoperitoneum(T4),5minutes after closure of pneumoperitoneum(T5).The body temperature(T),end tidal carbon dioxide partial pressure(PETCO2),heart rate(HR),airway pressure(Paw)and the time of pulling out laryngeal were masked in two groups.The results of the monitoring during the operation of two groups were compared.1.There was no significant difference in general data between the two groups before operation(P > 0.05).2.There was no significant difference in body temperature between two groups at T0(P > 0.05).Compared with control group,at T1-5,the experimental group remained stable body temperature,In the control group,the body temperature showed a downward trend,and there may a significant difference(P < 0.05).3.There was no significant difference in heart rate between the two groups at T0-1(P > 0.05).At T2-5,the heart rate of the control group was significantly slower than that in the experimental group(P < 0.05).In the experimental group,the heart rate was slow at T1(P <0.05).The heart rate of T2-5 was stable(P > 0.05).In the control group,the heart rate decreased at T1,but increased rapidly in T2,and the T3-5 heart rate slowed down(P < 0.05).4.T1-5 at each time point,the carbon dioxide partial pressure of the experimental group was significantly lower than that of the control group(P < 0.05),while T2-5 and T1 increased(P < 0.05),and the change was most obvious at T2 point,and then stabilized.5.T1-5 at each time point,there was no significant difference in airway pressure between the two groups(P > 0.05),compared with T1,the airway pressure of T2-5 increased significantly(P < 0.05),and the change was most obvious at T2 point,and then stabilized.Through a comprehensive analysis,we come to the conclusion that for the children undergoing laparoscopic herniorrhaphy,the thermal protective blanket used during the operation prevent the hypothermia in the perioperative period,reduce the accumulation of carbon dioxide in the body,and shorten the patients recovery time after operation effectively,so as to ensure the safety of the perioperative period of children. |
PDF Full Text Request