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| Influences of perioperative temperature protection on brain oxygen metabolism and oxidative stress in the elderly patients with gastrointestinal surgery |
| MA Kun1 MI Meiyan2 MA Pengyu3 YANG Yunliang3 ZHAO Jianhui3 |
1.Department of Anaesthesiology, the Fourth Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050011, China;
2.Shijiazhuang Fourth Hospital Women Division, Hebei Province, Shijiazhuang 050011, China;
3.Department of Anaesthesiology, the First Hospital of Shijiazhuang, Hebei Province, Shijiazhuang 050011, China |
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Abstract Objective To investigate the influences of perioperative temperature protection on brain oxygen metabolism and oxidative stress in the elderly patients with gastrointestinal surgery. Methods The clinical case data of 105 cases of elderly patients with gastrointestinal surgery from January 2016 to November 2017 in the Fourth Hospital of Shijiazhuang were retrospectively analyzed, including of routine perioperative treatment as routine group (51 cases) and routine perioperative + heat treatment as study group (54 cases). The body temperature (Temp), heart rate (HR) and mean arterial pressure (MAP) were compared before anesthesia (T1), after 15 mins of operation (T2), immediately after operation (T3) and 2 h after operation (T4), as well as the blood oxygen partial pressure (PjvO2), blood oxygen saturation (SjvO2), blood oxygen content (CjvO2) and lactate in jugular vein blood (JVL) and serum levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and the occurrence of chills and irritability and postoperative recovery time were observed. Results The values of Temp, HR and MAP of the study group had no obvious fluctuation (P > 0.05), of which the routine group at T2, T3 and T4 were significantly lower than those at T1 (P < 0.05), of which the routine group at T3 and T4 were significantly lower than those at T2 (P < 0.05). Except T1, the Temp of the study group were significantly higher than those of the routine group (P < 0.05), and the HR and MAP of the study group were significantly lower than those of the routine group (P < 0.05). Except T1, the PjvO2, SjvO2, CjvO2, SOD and GSH-Px of the study group were significantly higher than those of the routine group (P < 0.05), and the JVL and MDA of the study group were significantly lower than those of the routine group (P < 0.05). The incidence rates of chills and irritability of the study group were significantly lower than those of the routine group (P < 0.01), and the recovery time after operation of the study group was significantly shorter than that of the routine group (P < 0.01). Conclusion Perioperative temperature protection can maintain the stability of the life signs of the elderly patients with gastrointestinal surgery, obviously improve the brain oxygen metabolism and oxidative stress response, reduce the occurrence of chills and irritability and shorten the recovery time.
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[1] 赵津津，吴敬彰，史双友，等.右美托咪定复合依托咪酯对老年胃肠道疾病手术患者血流动力学稳定性及术后炎症反应的影响[J].广东医学，2016，37（18）：2817-2820.
[2] 苏文杰，牟玲，兰志勋.术中保温对老年患者全麻BIS恢复时间及苏醒期丙泊酚效应室浓度的影响[J].临床麻醉学杂志，2015，31（8）：770-772.
[3] 郑超，乔陈财，唐红军，等.探究亚低温脑保护对创伤性颅脑损伤的治疗效果[J].检验医学与临床，2016，13（12）：1646-1647.
[4] 陈立建，毛煜，赵仙雅，等.多模式保温对精准肝切除术中低体温发生的影响[J].中华麻醉学杂志，2016，36（6）：705-707.
[5] 贾风菊，刘惠，孙奇，等.围术期保温对腹部手术患者复苏及术后恢复的影响[J].中华现代护理杂志，2016，22（17）：2389-2393.
[6] 苟全霞.手术室术中保温干预对老年股骨骨折患者出血量、体温及术后凝血功能的影响[J].血栓与止血学，2017， 23（3）：501-503.
[7] 罗晓琴，张檀，刘庆，等.围手术期保温对胃癌手术患者凝血功能和应激指标的影响研究[J].癌症进展，2016，14（7）：681-683.
[8] 吴春梅，戴靖华，张旭，等.复合保温措施预防胃癌根治术病人术中低体温的效果观察[J].护理研究，2017，31（23）：2868-2872.
[9] 郭瑞娟，陈志惠，刘洁，等.手术室麻醉苏醒期护理对腹部手术患者全身麻醉苏醒期躁动及血压、心率的影响[J].检验医学与临床，2018，15（3）：399-401.
[10] 喻丽丽，栾昕.全麻患者围术期保温护理对患者应激及苏醒状况的效果[J].实用临床医药杂志，2017，21（10）：94-96.
[11] 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（3）：325-328.
[12] 张庆梅，夏晓琼，尹学军.体温保护对剖腹胃癌根治术患者快速康复的影响[J].临床麻醉学杂志，2018，34（1）：29-32.
[13] 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（4）：351-353.
[14] 昝向阳，向兴刚，蔡宁，等.乌司他丁对重型颅脑损伤患者脑氧代谢、炎性因子及肾功能的影响[J].现代生物医学进展，2017，17（29）：5694-5697.
[15] 杨志萍.围术期保温措施在经皮肾镜取石术中的研究应用[J].实用临床医药杂志，2017，21（8）：124-126.
[16] 韦秋凤，陈小健，冯丝丝，等.右美托咪定对全髋关节置换术患者脑氧代谢与能量代谢的影响[J].广西医科大学学报，2017（5）：743-745.
[17] 李禹.乌司他汀与右美托咪定对幕上肿瘤切除术患者脑氧供需及能量代谢的影响[J].中国肿瘤临床与康复，2017，24（3）：316-318.
[18] 王礼伟，程海涛.不同麻醉方法对腹腔镜结肠癌手术患者免疫及氧化性应激反应的影响[J].检验医学与临床，2017，14（15）：2315-2317.
[19] Gon?觭alves AC，Alves R，Baldeiras I，et al. Genetic variants involved in oxidative stress，base excision repair，DNA methylation，and folate metabolism pathways influence myeloid neoplasias susceptibility and prognosis [J]. Mol Carcinog，2017，56（1）：130.
[20] 李红英，陈晓玉.术中保温护理对人工髋关节置换术患者凝血功能及术后苏醒的影响[J].河北医学，2015，21（4）：671-674. |
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