经典非转流术式对原位肝移植术中患者体温的影响【临床医学毕业论文设计，精品】.doc

《经典非转流术式对原位肝移植术中患者体温的影响【临床医学毕业论文设计，精品】.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、临床医学论文-经典非转流术式对原位肝移植术中患者体温的影响作者：赵海萍，李爱民，冯国辉〔摘要〕冃的通过观察经典非转流原位肝移植术中患者体温变化的规律，捉供有效的体温保护措施。方法将15例晩期肝病患者，ASAin〜IV级，择期行OLT手术，麻醉诱导后使用BaxterVigilance连续心输出量测定仪连续测定心输出量（CO），混合静脉血氧饱和度及中心静脉血温，监测ECG、CVP、PETCO2、SpO2、棧动脉压、肺动脉压。术中采用四肢覆盖棉垫、手术床铺电温毯、加温输注液体、温盐水冲洗腹腔等措施，维持患者体温。麻醉后将温度探头置入患者食管连续监测食管温度。结果食管温度无肝期30min和新肝

2、期30min与切皮前即刻比较，差异有非常显著性（P<0.01）。术中发生体温过低（低于36.0°C）12例（80%），1例最低体温为33.3°C，发生在新肝早期。发生室性早搏3例，1例发生室性早搏时体温过低（33.5°C），经处理后恢复正常，无心跳骤停发生。结论经典非转流肝移植术中患者极易发生体温过低，以无肝晚期及新肝早期体温最低，体温保护措施可减少体温过低的发生率、减轻发生低体温的程度。〔关键词〕肝移植术；体温；护理Effectofclassicsunturn-.flowinginbodytemperatureofpatientduringorthotopiclivertranspl

3、antation[Abstract]ObjectiveToobservetheeffectsofclassicsunturn-.flowinginbodytemperatureofpatientduringorthotopiclivertransplantationandtoprovidethebasisforstrengtheningcareintemperatureofpatient・MethodsASAIHorVgradefifteenpatientsundergoneorthotopiclivertransplantation.Afteranesthesiainduced,ca

4、rdiacoutput,mixdvenousoxygensaturationandcentralvenoustemperaturewerecontinuouslymoniloredduringoperation.ECXj,CzP,SpO2,PETCO2,radialarteryandMPAPwerealsocontinuouslymonitoredduringoperation.Armsandlegswerecoveredcottoncushionintheoperation.Bedofoperationwasextendedelectrichotcarpetintheoperati

5、on.Forprotectionbodytemperature,1iquidofinjectionwasbeingheatedandwarmsalwaterwashedabdominalcavily.Bodytemperatureapparatusoftheinstallingesophagusmonitoredsimultaneouslytemperatureoftheesophagus.ResultsEsophagustemperatureweremorehigherin30minafterliverremovedandin30minafterreperfusionofthegra

6、ftthanthatofbeforeskinincisionin30min(P<0.01)・Thereare12casesin1owertemperature.Thereisacasein1owesttemperatureduringearlytimeafterreperfusionofthegraft・Threecasestookplaceventricularearlybeatrhythmical1y.Acaseoccurredventricularearlybeatrhythmicallyinmuch1owertemperature.Noonehappenedheartfailu

7、re.ConclusionBodytemperatureofpatientinclassicsunlurn・.flowingduringorthotopiclivertransplantationfalleasylow.Tcmpcrdturcisthe1owestatlatelytimeafter1iverremovedandearlytimcafterreperfusionofthegraftprotectiontemperaturecano