| Objective To investigate the effect of perioperative hypothermia on coagulation function and immune function in patients undergoing shoulder arthroscopy and their correlation.Methods Seventy patients with shoulder arthroscopy under general anesthesia in the our hospital operating room from December 2016 to December 2018 were selected,they were randomly divided into control group(group C,n=35)and study group(group S,n=35).Group C only uses conventional thin and sterile single insulation,and does not do other insulation treatment,the S group was infused with a liquid warmer(heating temperature 37.0?)on the basis of conventional conventional thin and sterile single insulation.The nasopharyngeal temperature of the two groups of patients into the operating room(T1),45 minutes after the start of surgery(T2),90 minutes after the operation(T3),and end of surgery(T4)were monitored and recorded;Observed the decrease in body temperature at the end of surgery in the two groups of patients;The iliac artery blood was collected by coagulation method and immunoturbidimetric assay to determine prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),complement C3,complement C4 and C-reactive protein(CRP)were determined by immunoturbidimetric assay.Results(1)Compared with group C,there were no significant difference in age,height,weight,fentanyl dosage,fluid input,duration of surgery,amount of irrigation fluid,urine volume,heart rate,systolic blood pressure,diastolic blood pressure,blood oxygen and bispectral index(BIS)between the two groups(p>0.05).(2)Compared with T1,the nasopharyngeal temperature of both groups decreased significantly at T2~T4,and the difference was statistically significant(p<0.05).Compared with groupC,there was no significant difference of change of nasopharyngeal temperature in group S patients at T1(p>0.05);At T3,the temperature of nasopharyngeal in group S increased significantly,and the difference was statistically significant(p<0.05);Compared with group C,the number of hypothermia in the S group decreased at the end of the operation,and the incidence also decreased,the difference was statistically significant(p<0.05).(3)Compared with T1,PT,APTT and TT were prolonged,the content of FIB,complement C3 and complement C4 at T2 to T4 were decreased,and the difference were statistically significant(p<0.05).Compared with group C,there was no significant difference of the S group in the prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)at T1(p>0.05),there were no significant difference in the content of fibrinogen(FIB),complement C3 and complement C4 at T1(p>0.05);The time of prothrombin time(PT),activated partial thromboplastin time(APTT),and thrombin time(TT)in group S at T3 was significantly prolonged,and fibrinogen(FIB),complement C3,and complement C4 were significantly increased,the difference was statistically significant(p<0.05);(4)Compared with T1,there were a positive correlation between the complement C3 and fibrinogen in T2~T4(r=0.44,r>0,p<0.05),and the difference was statistically significant;There was a negative correlation between the prothrombin time and complement C4(r=-0.34,r<0,p<0.05),and the difference was statistically significant.(5)There was no difference in C-reactive protein at each time point.Conclusion In shoulder arthroscopy,the incidence of hypothermia is higher,and active thermal insulation can reduce the incidence of hypothermia and ensure the stability of body temperature.With the decrease of body temperature,prolonged clotting time,decreased fibrinogen and increased complement consumption,there were a positive correlation between complement C3 and fibrinogen,and a negative correlation between complement C4 and prothrombin time. |
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