围术期低体温的防治与进展

Prevention and Progression of Perioperative Hypothermia

摘要: 围术期体温过低(一般指核心温度 < 36℃)是手术中患者常见的不良事件。主要包括以下外部因素，例如药物使用、并发症、创伤、手术的部位和持续时间、周围环境温度以及麻醉类型，都会影响核心温度。围术期低体温对凝血功能、出血量和输血量、药物代谢、术后感染和住院时长有负面影响。因此，需要在术前、术中和术后给予积极的体温管理，来降低围术期低体温的风险。在围术期积极维持体温正常对于提升手术效果以及患者安全和手术满意度是非常重要的。体温监测应使用连续和准确的体温探头进行。围术期体温管理需要配置合适的加温工具，加热毯子和床垫以及专用的输液加温设备进行适当加热显得非常重要。本文综述了体温调节的生理学、麻醉和手术引起的体温调节变化、围术期体温过低的后果、核心温度测量方法以及围手术期的温度管理，旨在解释围术期低体温的机制，强调其防治的重要性，并就如何完善体温管理提供具体建议。

Abstract: Perioperative hypothermia (generally refers to the core temperature < 36˚C) is a common adverse event in patients during surgery. Mainly including the following external factors, such as drug use, complications, trauma, site and duration of surgery, ambient temperature, and type of anesthesia, can affect the core temperature. Perioperative hypothermia has a negative effect on coagulation function, blood loss and transfusion volume, drug metabolism, postoperative infection, and length of hospital stay. Therefore, active temperature management needs to be given before, during and af-ter surgery to reduce the risk of perioperative hypothermia. Actively maintaining normal body temperature during the perioperative period is important to improve surgical outcomes as well as patient safety and surgical satisfaction. Temperature monitoring should be performed using both continuous and accurate body temperature probes. Perioperative temperature management re-quires the configuration of appropriate heating tools, heating blankets and mattresses, and special infusion heating equipment for appropriate heating is very important. This paper summarizes the physiology of thermoregulation, thermoregulation changes caused by anesthesia and surgery, the consequences of perioperative hypothermia, core temperature measurement methods and periop-erative temperature management, aiming to explain the mechanism of perioperative hypothermia, emphasize the importance of prevention and treatment, and provide specific suggestions on how to improve body temperature management.