Abstract:

Objective: To investigate the effect of perioperative body temperature protection on postoperative rehabilitation of patients with oral cancer. Methods: 98 patients with oral cancer underwent radical resection and simultaneous free skin flap repair were divided into two groups: heat preservation group(n=49) and control group(n=49). The heat preservation group was given resistive heating pad and warm infusion for body temperature protection. The core body temperature of the two groups was recorded at each time point, and the operating room temperature, anesthetic time, anesthetic medication, intraoperative blood loss, blood transfusion, transfusion volume, flushing fluid volume, urine volume, operation time length, resuscitation time length, incidence of postoperative shivering, postoperative infection rate, incidence of unplanned secondary operation and hospital stays were recorded. Results: Compared with those before anesthesia, the core temperature of the two groups decreased significantly at 2 h, 4 h, 6 h after anesthesia. when transferred to postanesthesia care unit(PACU) and out of PACU, and that in the heat preservation group at 2 h, 4 h, 6 h after anesthesia, the core temperature in the heat preservation group was significantly higher than that in the control group(P<0.05). Compared with the control group, the intraoperative blood loss, blood transfusion, postoperative shivering and resuscitation time length in the heat preservation group were significantly lower(P<0.05), and the total incidence of postoperative infection and hospital stays were significantly shorter in the heat preservation group(P<0.05). There was no significant difference in operating room temperature, anesthetic time length, anesthetic medication, operation time length, intraoperative infusion volume, flushing fluid volume, urine volume and the incidence of unplanned secondary operation between the two groups. Conclusion: Heat preservation measure can accelerate the recovery after surgery in patients with oral cancer through preventing the occurrence of hypothermia, decreasing the incidence of postoperative infection and shortening hospitalization time.

Key words: temperature protection, oral cancer, perioperative hypothermia, enhanced recovery after surgery

摘要：

目的：探讨围术期体温保护对口腔癌患者术后加速康复的影响。方法：选择口腔癌根治术加同期游离皮瓣修复术患者98例为研究对象，分为保温组和对照组，每组各49例。保温组给予电阻式加温垫和温输液进行体温保护。记录2组患者各时间点核心体温；记录手术室温度，麻醉时间，麻醉用药，术中出血量、输血量、输液量、冲洗液量、尿量，手术时间，复苏时间，术后寒战发生率，术后感染率，非计划二次手术发生率及住院时间。结果：与麻醉前比较，2组患者麻醉后2、4、6 h，转入麻醉后监测治疗室（postanesthesia care unit，PACU）和转出PACU时的核心温度明显降低（P<0.05）；保温组麻醉后2、4、6 h，转入PACU和转出PACU时的核心温度明显高于对照组（P<0.05）。与对照组比较，保温组术中出血量、输血量小（P<0.05），术后寒战发生率低（P<0.05），复苏时间短（P<0.05），术后总感染发生率低（P<0.05），住院时间明显缩短（P<0.05）。2组手术室温度，麻醉时间，麻醉用药，手术时间，术中输液量、冲洗液量、尿量及非计划二次手术发生率差异无统计学意义。结论：体温保护能够有效预防口腔癌患者围术期低体温的发生，降低术后感染率，缩短住院时间，从而促进患者加速康复。

关键词: 体温保护, 口腔癌, 围术期低体温, 术后加速康复

CLC Number: 

• R782

• R739.8