马正良;易杰;

• 1:国家麻醉专业质量控制中心中华医学会麻醉学分会
• 2:南京大学医学院附属鼓楼医院
• 3:北京协和医院

摘要(Abstract)：

<正>体温、血压、脉搏、呼吸和疼痛共同构成了生命五大体征,保持体温恒定是保证机体新陈代谢和正常生命活动的必要条件,而体温异常可引起代谢功能紊乱甚至危及生命。正常人核心体温为36.5~37.5℃,体表温度为33℃左右。核心体温是指机体深部重要脏器的温度,与体表温度相对应,二者之间温度梯度约为2~4℃。围手术期由于各种原因导致机体核心

关键词(KeyWords)： 围手术期;低体温;专家共识

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 马正良;易杰;

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参考文献(References)：

• [1]Sessler DI.Mild periopaerative hypothermia[J].N Engl J Med,1997,336:1730-1737.
• [2]Slotman GJ,Jed EH,Burchard KW.Adverse effects of hypothermia in postoperative patients[J].Am J Surg,1985,149:495-501.
• [3]Schmied H,Kurz A,Sessler DI,et al.Mild hypothermia increases blood loss and transfusion requirements during total hip arthroplasty[J].Lancet,1996,347:289-292.
• [4]Yi J,Xiang Z,Deng X,et al.Incidence of inadvertent intraoperative hypothermia and its risk factors in patients undergoing general anesthesia in Beijing:a prospective regional survey[J].PLo S One,2015,10:e0136136.
• [5]Yi J,Lei Y,Xu S,et al.Intraoperative hypothermia and itsclinical outcomes in patients undergoing general anesthesia:national study in China[J].PLo S One,2017,12:e0177221.
• [6]Tappen RM,Andre SP.Inadvertent hypothermia in elderly surgical patients[J].AORN J,1996,63:639-644.
• [7]Forbes SS,Eskicioglu C,Nathens AB,et al.Evidence-based guidelines for prevention of perioperative hypothermia[J].J Am Col Surg,2009,209:492-503.
• [8]Miller RD,Cohen NH,Eriksson LI,et al.Miller's Anesthesia[M].Sessler DI.8th ed.Phila-delphia USA:Elsevier,2015:1622-1644.
• [9]Sessler DI.Perianesthetic thermoregulation and heat balance in humans[J].FASEB J,1993,7:638-644.
• [10]Scott AV,Stonemetz JL,Wasey JO,et al.Compliance with surgical care improvement project for body temperature management(SCIP Inf-10)is associated with improved clinical outcomes[J].Anesthesiology,2015,123:116-125.
• [11]Frank SM,Beattie C,Christopherson R,et al.Unintentional hypothermia is associated with postoperative myocardial ischemia.The Perioperative Ischemia Randomized Anesthesia Trial Study Group[J].Anesthesiology,1993,78:468-476.
• [12]Frank SM,Fleisher LA,Breslow MJ,et al.Perioperative maintenance of normothermia reduces the incidence of morbid cardiac events.A randomized clinical trial[J].JAMA,1997,277:1127-1134.
• [13]Kurz A,Sessler DI,Lenhardt R.Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization[J].N Engl J Med,1996,334:1209-1215.
• [14]张俊烁,褚忠华,方喜,等.不同术中保温对开腹手术患者低体温及手术部位感染的影响[J].中国临床药理学杂志,2015,31:1834-1836.
• [15]仓静,张俊峰,薛张纲,等.术中保温对食管癌根治术患者凝血功能的影响[J].中华麻醉学杂志,2006,26:35-38.
• [16]宋瑞月,易杰,黄宇光.不同保温策略对剖宫产患者术中寒战发生率的影响[J].基础医学与临床,2016,36:4-7.
• [17]唐佳,李冬雪,王志成.老年围术期低体温与感染的相关性研究[J].中华医院感染学杂志,2015,25:418-420.
• [18]Hedrick TL,Heckman JA,Smith RL,et al.Efficacy of protocol implementation on incidence of wound infection in colorectal operations[J].J Am Col Surg,2007,205:432-438.
• [19]Mahoney CB,Odom J.Maintaining intraoperative normothermia:a meta-analysis of outcomes with costs[J].AANA J,1999,67:155-163.
• [20]Leslie K,Sessler DI,Bjorksten AR,et al.Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium[J].Anesth Analg,1995,80:1007-1014.
• [21]Yi J,Zhan L,Lei Y,et al.Establishment and validation of a prediction equation to estimate risk of intraoperative hypothermia in patients receiving general anesthesia[J].Scientific Report(accepted in press),2017.
• [22]Bock M,Muller J,Bach A,et al.Effects of preinduction and intraoperative warming during major laparotomy[J].Br J Anaesth,1998,80:159-163.
• [23]Melling AC,Ali B,Scott EM,et al.Effects of preoperative warming on the incidence of wound infection after clean surgery:a randomised controlled trial[J].Lancet,2001,358:876-880.
• [24]Hooper VD,Chard R,Clifford T,et al.ASPAN's evidencebased clinical practice guideline for the promotion of perioperative normothermia[J].J Perianesth Nur,2009,24:271-287.
• [25]Morris RH.Influence of ambient temperature on patient temperature during intraabdominal surgery[J].Ann Surg,1971,173:230-233.
• [26]Morris RH,Wilkey BR.The effects of ambient temperature on patient temperature during surgery not involving body cavities[J].Anesthesiology,1970,32:102-107.
• [27]夏海禄,易杰,黄宇光.充气式温毯预保温联合液体加温对肺叶切除术患者体温及热舒适度的影响[J].基础医学与临床,2017,37:718-722.
• [28]梁小霞.充气式升温毯在经皮肾镜取石术中预防患者寒战的效果评价[J].实用临床护理学杂志,2017,2:70-71.
• [29]梁浩,易杰.主动充气式保温系统预防大手术患者术中低体温的效果[J].中国医学科学院院报,2017,39:4-7.
• [30]王金鑫,李菊红,吴福丽.充气式升温毯对烧伤整形患者术中低体温预防效果观察[J].人民军医,2016,59:34-35.
• [31]章敏,谢言虎,周玲,等.充气式保温毯联合输液加温对全麻食管癌手术苏醒和免疫功能的影响[J].临床麻醉学杂志,2016,32:351-353.
• [32]红霞,佟婉云,韩志强.充气加温毯在结肠癌患者手术不同时机的应用[J].中国肿瘤临床与康复,2017,24:325-328.
• [33]肖颖,陈樱,林世清,等.充气加温法对围手术期轻度低体温的预防作用[J].岭南急诊医学杂志,2003,8:90-94.
• [34]葛亚历,朱雯霏,王永浩,等.充气式加温系统对腰硬联合麻醉剖宫产术后寒战的影响[J].中华临床医师杂志(电子版),2013,7:882-883.
• [35]Camus Y,Delva E,Cohen S,et al.The effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery[J].Acta Anaesth Scand,1996,40:779-782.
• [36]Smith CE,Desai R,Glorioso V,et al.Preventing hypothermia:convective and intravenous fluid warming versus convective warming alone[J].J Clin Anesth,1998,10:380-385.
• [37]Smith CE,Gerdes E,Sweda S,et al.Warming intravenous fluids reduces perioperative hypothermia in women undergoing ambulatory gynecological surgery[J].Anesth Analg,1998,87:37-41.
• [38]NICE.Hypothermia:prevention and management in adults having surgery[EB/OL].https://www.niceorguk/guidance/cg65/2016.
• [39]白雪玲,江燕华,陈慎.使用充气升温机在经尿道等离子前列腺电切术的效果观察[J].吉林医学,2013,34:2564.
• [40]黄倩,王宏梗,范春梅.输血输液加温仪在库存红细胞悬液输注过程中的应用效果[J].临床麻醉学杂志,2015,31:973-975.
• [41]Bernard H.Patient warming in surgery and the enhanced recovery[J],Br J Nurs,2013,22:22-25,319-320.
• [42]Ljungqvist O,Scott M,Fearon KC.Enhanced Recovery After Surgery:A Review[J].JAMA Surg,2017,152:292-298.