摘要
目的探讨围手术期体温保护对行不停跳冠脉搭桥术老年患者的影响。方法选择2017年12月~2019年5月河北医科大学第一医院和河北医科大学第四医院收治的择期行不停跳冠脉搭桥术老年患者78例,随机分为对照组和观察组各39例,对照组接受常规手术室体温保护,观察组接受围手术期体温前瞻性保护,比较两组患者围手术期不同时间段的生命体征、术后的凝血功能和围手术期指标。结果观察组患者手术开始、手术1 h和手术结束1 h心率(HR)和平均动脉压(MAP)水平均低于对照组患者(P <0.05),观察组手术后的凝血酶时间(TT)、凝血酶原时间(PT)、部分凝血活酶时间(APTT)和纤维蛋白(FIB)水平均低于对照组患者(P <0.05),观察组术中出血量、输血量、输液量、术后苏醒和拔管时间均低于对照组患者(P <0.05)。结论围手术期体温前瞻性保护能够有效控制行不停跳冠脉搭桥术老年患者的生命体征和凝血功能,保障手术治疗的效果,有助于改善愈后。
Objective To explore the ffects of perioperative protection of body temperature on elderly patients undergoing off-pump coronary artery bypass grafting(CABG).Methods A total of 78 elderly patients who were admitted to the First Hospital of Hebei Medical University and the Fourth Hospital of Hebei Medical University from December 2017 to May 2019 and underwent selective off-pump CABG were randomly divided into a control group(n=39)and an observation group(n=39).Conventional protection of body temperature in the operating room was conducted for the control group,and prospective protection of body temperature in the perioperative period was performed for the observation group.The two groups were compared in terms of vital signs at different stages of perioperative period,post-operative coagulation functions and perioperative indicators.Results The heart rate(HR)and levels of mean arterial pressure(MAP)in the observation group were lower than that in the control group at the beginning of the operation,al one hour during the operation,and at one hour after the operation(P<0.05).The thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)levels in the observation group were all lower than that in the control group(P<0.05).The intraoperative amount of bleeding,amount of blood transfusion and amount of fluid infusion as well as the postoperative awakening time and extubation time in the observation group were all lower than that in the control group(P<0.05).Conclusion Prospective protection of body temperature in the perioperative period can ffctively control the vital signs and coagulation functions of the elderly patients undergoing off-pump CABG,guarantee the efficacy of surgical treatment and help to improve the prognosis.
作者
张改欣
杨芳
张丛
祖金美
Zhang Gaixin;Yang Fang;Zhang Cong;Zu Jinmei(Operating Room,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei,050031,China;Department of Thoracic Surgery,the Fourth Hospital of Hebei Medical University,Shijiazhuang,Hebei,050031,China;Department of General Surgery,the First Hospital of Hebei Medical University,Shijiazhuang,Hebei,050031,China)
出处
《西南国防医药》
CAS
2020年第5期434-436,共3页
Medical Journal of National Defending Forces in Southwest China
基金
河北省自然科学基金资助项目(F2018202365)。
关键词
不停跳冠脉搭桥
老年患者
围手术期
体温保护
凝血功能
生命体征
off-pump CABG
elderly patients
perioperative period
protection of body temperature
coagulation function
vital signs
