目的:建议麻醉下手术患者术中保温,但在椎管内麻醉下的剖宫产患者中,这方面的研究还不充分。这项研究的目的是确定选择性剖宫产术中主动加温对母亲和新生儿的影响。
方法:这项研究是在一项实验设计中进行的,该实验设计采用了前测-后测随机干预和对照组。
方法:这项研究对34名妇女(17名干预者和17名对照者)进行了研究,剖腹产。该研究检查了母亲和新生儿的结局。干预组的女性通过主动加热(手术期间用碳纤维电阻式车底加热器加热)和被动加热(术前袜子,不带电的羊毛毯子,etc).对照组(术前)仅对妇女采用被动加热方法。新生儿活动-脉搏-阴险-出现-呼吸(APGAR)评分,体温,皮质醇,观察干预组和对照组的血糖水平,同时评估母亲的体温和颤抖情况。
结果:剖宫产后干预组和对照组婴儿的体温和第一分钟APGAR评分分别为36.88±0.27、36.52±0.32(P=.002);7.00±0.36、7.47±0.64(P=.009),分别。干预组和对照组的皮质醇和血糖水平分别为3.55±1.09、4.51±0.70(P=.010)。77.94±7.07,72.47±10.24(P>.05),分别。干预组和对照组在15、30和45分钟时的体温差异有统计学意义(P<0.05)。而在60分钟时它们相似(P>.05)。干预组术中30分钟血氧饱和度为97.10±1.41,对照组为95.20±1.78(P<0.05)。
结论:主动变暖之前,during,剖宫产后影响体温,脉搏,呼吸,血压,和女性的氧饱和度,虽然它提高了新生儿的体温和APGAR评分,它降低了皮质醇水平。
OBJECTIVE: Intraoperative warming is recommended for surgical patients under anesthesia, but there are insufficient studies on this topic in cesarean delivery patients under spinal anesthesia. The purpose of this study was to determine the effects of active warming on the mother and newborn during elective cesarean section.
METHODS: This research was carried out in an experimental design with a pretest-posttest randomized intervention and control group.
METHODS: The research was conducted with 34 women (17 intervention and 17 control), who gave birth by cesarean section. The study examined outcomes for both mother and newborn. Women in the intervention group were heated by both active (warmed with carbon fiber resistive underbody heaters during surgery) and passive heating (preoperative- socks, nonelectrified wool blankets, etc). Only passive heating methods were applied to the women in the control group (preoperative). Neonatal Activity - Pulse - Grimace - Appearence - Respiration (APGAR) score, body temperature, cortisol, and blood glucose levels in the intervention and control groups were evaluated, while body temperature and shivering conditions were evaluated in the mother.
RESULTS: Body temperature and first minute APGAR score of the infants in the intervention and control groups after cesarean section were 36.88 ± 0.27, 36.52 ± 0.32 (P = .002); 7.00 ± 0.36, 7.47 ± 0.64 (P = .009), respectively. Cortisol and blood glucose levels in the intervention and control groups were 3.55 ± 1.09, 4.51 ± 0.70 (P = .010), 77.94 ± 7.07, 72.47 ± 10.24 (P > .05), respectively. The body temperatures of the women in the intervention and control groups at 15, 30, and 45 minutes were significantly different (P < .05), while they were similar (P > .05) at 60 minutes. Oxygen saturation measured at 30 minutes during the operation was 97.10 ± 1.41 in the intervention group and 95.20 ± 1.78 in the control group (P < .05).
CONCLUSIONS: Active warming before, during, and after cesarean section affected body temperature, pulse, respiration, blood pressure, and oxygen saturation of women, and while it increased the body temperature and APGAR score of newborns, it decreased cortisol level.