李云现 甘泉涌 孟松 潘同柱 马璐 汪欢欢

[摘 要]目的 探討术中体温保护措施对全麻吸脂整形手术患者麻醉效果的影响。方法 选取我院2021年3月-2023年3月收治的150例吸脂整形手术者为研究对象，随机分为参照组与研究组，每组75例。参照组采取常规体温保护，研究组在参照组基础上联合温度保护，比较两组不同时间点体表温度、食道中段温度及麻醉效果、应激反应指标、不良事件发生情况。结果 研究组手术实施60 min、术毕、拔管时刻的体表温度、食道中段温度均高于参照组，且研究组诱导时刻食道中段温度高于参照组（P<0.05）；研究组插管持续时间、完全清醒时间及麻醉监测室滞留时间均短于参照组（P<0.05）；两组术后肾上腺素、去甲肾上腺素及皮质醇指标均高于术前，但研究组低于参照组（P<0.05）；研究组不良事件发生率低于参照组（P<0.05）。结论 对全麻吸脂整形手术患者实施术中体温保护可有效保持患者体温处于一个正常状态，保障麻醉效果，积极减少术中发生严重应激反应及低体温等不良事件发生几率，有利于保障手术治疗顺利开展。

[关键词] 吸脂整形手术；全麻；温度保护；应激反应

[中图分类号] R622 [文献标识码] A [文章编号] 1004-4949（2024）05-0151-04

Effect of Intraoperative Temperature Protection on Anesthetic Effect for Patients with Liposuction Plastic Surgery Under General Anesthesia

LI Yun-xian， GAN Quan-yong， MENG Song， PAN Tong-zhu， MA Lu， WANG Huan-huan

（Department of Anesthesia， Hefei One and Only Cosmetic Hospital， Hefei 230022， Anhui， China）

[Abstract]Objective To investigate the effect of intraoperative temperature protection measures on the anesthetic effect for patients with liposuction plastic surgery under general anesthesia. Methods A total of 150 patients with liposuction plastic surgery admitted to our hospital from March 2021 to March 2023 were selected as the research objects and randomly divided into reference group and study group， with 75 patients in each group. The reference group was given routine temperature protection， and the study group was combined with temperature protection on the basis of the reference group. The body surface temperature and mid-esophageal temperature at different time points， anesthetic effect， stress response index and adverse events were compared between the two groups. Results The body surface temperature and middle esophageal temperature of the study group were higher than those of the reference group at 60 min， end of operation and extubation， and middle esophageal temperature of the study group was higher than that of the reference group at induction （P<0.05）. The intubation duration， complete awake time and anesthesia monitoring room retention time in the study group were shorter than those in the reference group （P<0.05）. The indexes of epinephrine， norepinephrine and cortisol in the two groups after operation were higher than those before operation， but those in the study group were lower than those in the reference group （P<0.05）. The incidence of adverse events in the study group was lower than that in the reference group （P<0.05）. Conclusion Intraoperative body temperature protection for patients undergoing liposuction plastic surgery under general anesthesia can effectively maintain their body temperature in a normal state， ensure the anesthetic effect， and actively reduce the incidence of adverse events such as severe stress response and hypothermia during surgery， which is conducive to ensuring the smooth development of surgical treatment.

[Key words] Liposuction plastic surgery； General anesthesia； Temperature protection； Stress reaction

近年随着人们健康思想观念的转变及对美的不断追求，吸脂整形手术逐渐成为部分体重过重或是追求“瘦身”者选择的一种形体塑形方式[1]。但由于吸脂手术具有一定创伤性及术中有较多的不可控因素，常会导致患者发生应激反应及低体温等不良事件，增加手术治疗风险。全身麻醉术中体温会明显丢失更快，若不及时采取有效干预，极其容易导致术中出现严重应激反应、呼吸抑制或是苏醒延迟等事件[2]。同时，体温是人体重要的生命体征，手术过程中恒定的体温是维持患者身体各项机能的重要保障，因而在手术过程中需进一步实施温度保护，做好相应的保温措施[3]。既往临床在开展吸脂整形手术过程中，给予常规的手术室保温干预措施，虽能根据手术需求做好相应的基础措施，但多依靠医护人员自身主观工作经验进行管护，缺乏全面性及系统性，整体保温效果仍不理想，患者仍会出现寒战、应激反应，因而还需更为有效的辅助干预方式[4]。……