中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (44): 8230-8232.doi: 10.3969/j.issn.1673-8225.2010.44.015

• 器官移植临床实践 clinical practice of organ transplantation • 上一篇    下一篇

肾移植术中全麻患者的体温变化

吕晓明1，李睿坤2，宁吉顺1   

  1. 1解放军济南军区总医院麻醉科，山东省济南市 250031；2山东省高等医学专科学校，山东省济南市  250002
  • 出版日期:2010-10-29 发布日期:2010-10-29
  • 作者简介:吕晓明☆，男，1972年生，山东省淄博市人，汉族，山东大学在读博士，主治医师，主要从事围术期低体温研究。 wy740328@sina.com

Body temperature changes of patients during renal transplantation under general anesthesia

Lü Xiao-ming1, Li Rui-kun2, Ning Ji-shun1   

  1. 1 Department of Anaesthesiology, General Hospital of Jinan Military Region, Jinan  250031, Shandong Province, China; 2 Shandong Medical College, Jinan  250002, Shandong Province, China
  • Online:2010-10-29 Published:2010-10-29
  • About author:Lü Xiao-ming☆, Studying for doctorate, Attending physician, Department of Anaesthesiology, General Hospital of Jinan Military Region, Jinan 250031, Shandong Province, China wy740328@sina.com

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423

被引次数

7

摘要：

背景：随着麻醉技术的进步，全麻在肾移植手术中的应用比例逐渐增多，但手术中患者体温的变化情况却鲜有报道。
目的：观察全麻肾移植手术中患者体温的变化。
方法：选择中末期肾功能衰竭行肾移植患者20例，以瑞芬太尼-丙泊酚全凭静脉麻醉。分别于麻醉诱导后、移植肾血管吻合前、移植肾血管开放前、移植肾血管开放后5，30，60 min 6个时间点记录患者体温。
结果与结论：与麻醉诱导后相比，移植肾血管吻合前、开放前患者体温变化不明显；移植肾血管开放后5，30 min体温明显降低；移植肾血管开放后60 min体温有所回升。说明全麻肾移植手术中确实有体温降低的现象。但观察整个变化过程可以发现，从麻醉诱导至移植肾血管开放前患者体温并没有明显下降，说明术中使用的全麻药物以及移植肾血管开放前的手术过程并不是造成患者体温降低的主要原因。而移植肾血管开放后5 min内患者体温迅速降低，说明移植肾血管开放后冷灌液进入患者血液循环才是患者体温下降的主要原因，而且这种体温下降可以持续很长时间，以至于移植肾血管开放后30，60 min患者体温仍难以恢复至移植肾血管开放前的水平。提示全麻肾移植手术中患者容易出现体温降低，移植肾血管开放后冷灌液进入患者血液循环是体温下降的主要原因。

关键词: 全麻, 肾移植, 体温, 麻醉, 移植

Abstract:

BACKGROUND: With advances of anesthetic techniques, the use of general anesthesia gradually increased in renal transplantation, however, the changes of body temperature during surgery has rarely reported.
OBJECTIVE: To investigate body temperature changes of patients during renal transplantation under general anesthesia. 
METHODS: A total of 20 cases that underwent renal transplantation under general anesthesia with remifentanil-propofol were selected. The body temperature was recorded at 6 points, namely, after anesthesia induction, before anastomosis of transplanted renal vascular, before transplanted renal artery opening, at minutes 5, 30 and 60 after transplant renal artery opening.
RESULTS AND CONCLUSION: Compared with after anesthesia induction, the body temperature had no obviously changes at before anastomosis of transplanted renal vascular and before transplanted renal artery opening, which dramatically decreased at minutes 5 and 30 after transplant renal artery opening, but recovered at minutes 60 after transplant renal artery opening. It demonstrated that the body temperature indeed depressed during renal transplantation. However, by observing the whole process, it found that there was no significant drop in body temperature from after induction of anesthesia to before transplant renal artery opening, which revealed anesthesia drugs and the surgery process was not the main reason for low body temperature. While, at 5 minutes after transplant renal artery opening, the body temperature rapidly decreased, it indicating cold irrigation fluid into patient’s blood circulation after the opening of transplant renal artery was the main reason for the low body temperature, and this could continue for a very long time, even could not recovered at 30 minutes and 60 minutes after transplant renal artery opening. Result suggests that patients underwent renal transplantation with general anesthesia prone to hypothermia, the cold irrigation fluid into the patient’s blood circulation after the opening of transplant renal artery is the main reason for hypothermia.

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