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Beneficial effect of fluid warming in elderly patients with bladder cancer undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy.

液体加温对接受达芬奇机器人辅助腹腔镜根治性膀胱切除术的老年膀胱癌患者的有益影响。

  • 影响因子:1.35
  • DOI:10.6061/clinics/2020/e1639
  • 作者列表:"Luo J","Zhou L","Lin S","Yan W","Huang L","Liang S
  • 发表时间:2020-04-17
Abstract

OBJECTIVES:The enhanced recovery after surgery (ERAS) protocol recommends prevention of intraoperative hypothermia. However, the beneficial effect of maintaining normothermia after radical cystectomy has not been evaluated. This study aimed to investigate the efficacy of fluid warming nursing in elderly patients undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy. METHODS:A total of 108 patients with bladder cancer scheduled to undergo DaVinci robotic-assisted laparoscopic radical cystectomy were recruited and randomly divided into the control group (n=55), which received a warming blanket (43°C) during the intraoperative period and the warming group (n=53), in which all intraoperative fluids were administered via a fluid warmer (41°C). The surgical data, body temperature, coagulation function indexes, and postoperative complications were compared between the two groups. RESULTS:Compared to the control group, the warming group had significantly less intraoperative transfusion (p=0.028) and shorter hospitalization days (p<0.05). During the entire intraoperative period (from 1 to 6h), body temperature was significantly higher in the warming group than in the control group. There were significant differences in preoperative fibrinogen level, white blood cell count, total bilirubin level, intraoperative lactose level, postoperative thrombin time (TT), and platelet count between the control and warming groups. Multivariate linear regression analysis demonstrated that TT was the only significant factor, suggesting that the warming group had a lower TT than the control group. CONCLUSION:Fluid warming nursing can effectively reduce transfusion requirement and hospitalization days, maintain intraoperative normothermia, and promote postoperative coagulation function in elderly patients undergoing Da Vinci robotic-assisted laparoscopic radical cystectomy.

摘要

目的: 加速康复外科 (ERAS) 方案推荐预防术中低体温。然而,尚未评估根治性膀胱切除术后维持常温的有益效果。本研究旨在探讨液体加温护理在达芬奇机器人辅助腹腔镜根治性膀胱切除术老年患者中的应用效果。 方法: 将108例拟行达芬奇机器人辅助腹腔镜根治性膀胱切除术的膀胱癌患者随机分为对照组 (n = 55) 和观察组 (n = 53),对照组术中使用加温毯 (43 ℃)。其中所有术中液体均通过液体加热器 (41 °C) 给药。比较两组患者的手术资料、体温、凝血功能指标及术后并发症发生情况。 结果: 与对照组相比,加温组术中输血量明显减少 (p = 0.028),住院天数明显缩短 (p<0.05)。在整个术中期间 (从1到6小时),体温在加温组明显高于对照组。对照组与加温组术前纤维蛋白原水平、白细胞计数、总胆红素水平、术中乳糖水平、术后凝血酶时间 (TT) 、血小板计数差异有统计学意义。多元线性回归分析表明,TT是唯一显著的因素,表明升温组的TT低于对照组。 结论: 液体加温护理可有效减少达芬奇机器人辅助腹腔镜根治性膀胱切除术老年患者的输液需求和住院天数,维持术中常温,促进术后凝血功能。

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