Feasibility of iThermonitor for Intraoperative Monitoring the Core Body Temperature during Ambulatory Surgery: A Prospective Diagnostic Test
-
摘要:
目的 观察日间手术中采用无线体温传感器持续监测核心体温的有效性和可行性。 方法 前瞻性收集从2017年10月25日至2017年12月8日, 在四川大学华西医院接受日间手术患者术中体温监测的数据, 每组数据包括食管温度、直肠温度和无线体温传感器监测的腋窝温度。以食管温度为标准, 计算腋窝温度及直肠温度与其差值, 并分析二者与食管温度的一致性。 结果 共113例符合纳入和排除标准的患者入选本研究, 采集到1451组体温监测数据。以食管温度为标准, 腋窝温度较食管温度低(0.06±0.26)℃, 而直肠温度较食管温度高(0.39±0.23)℃。相关分析显示腋窝温度(r=0.9331)较直肠温度(r=0.8431)更接近食管温度。腋窝温度在食管温度±0.5℃以内的比例为94.97%, 而直肠温度为78.91%。 结论 无线体温传感器用于成人日间手术术中持续核心体温监测是有效可行的。 Abstract:Objective The aim of this study was to observe the feasibility and effectiveness of iThermonitor for continuous monitoring of the core body temperature during ambulatory surgery. Methods The body temperatures of patients who underwent ambulatory surgery in West China Hospital from October 25 to December 8, 2017 were prospectively collected. Each set of data included the esophageal temperature, rectal temperature, and armpit temperature measured by iThermonitor.The esophageal temperature was used as the standard and subtracted from the armpit temperature and rectal temperature, respectively. SAS and R softwares were used for consistent analysis. Results A total of 113 patients meeting the inclusive and exclusive criteria were enrolled in this study, and 1451 sets of intraoperative temperature data were collected.The armpit temperature measured by iThermonitor was (0.06±0.26)℃ lower, while the rectal temperature was (0.39±0.23)℃ higher than the esophageal temperature. In terms of the correlation coefficient, iThermonitor temperature (r=0.9331) was closer to the esophageal temperature than the rectal temperature (r=0.8431). In respect of theproportion of falling into the esophageal temperature ±0.5℃, armpit temperature was 94.97% and the rectal temperature was 78.91%. Conclusion iThermonitor might be effectively used to monitor the core body temperature of adult patients during ambulatory surgery. -
Key words:
- iThermonitor /
- perioperative /
- core body temperature
利益冲突 无 -
表 1 日间手术患者腋窝温度、直肠温度与食管温度差值的比较
分类 差值(x±s, ℃) 差值范围(℃) 食管温度-腋窝温度 0.06±0.26 -0.70~0.90 食管温度-直肠温度 -0.39±0.23 -1.30~0.30 -
[1] 国家麻醉专业质量控制中心, 中华医学会麻醉学分会.围手术期患者低体温防治专家共识(2017)[J].协和医学杂志, 2017, 11:352-358. http://www.cnki.com.cn/Article/CJFDTotal-XHYX201706008.htm [2] Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization[J]. N Engl J Med, 1996, 334:1209-1215. doi: 10.1056/NEJM199605093341901 [3] 仓静, 张俊峰, 薛张纲, 等.术中保温对食管癌根治术患者凝血功能的影响[J].中华麻醉学杂志, 2006, 26:35-38. http://d.wanfangdata.com.cn/Periodical/zhmzxzz98200601011 [4] Leslie K, Sessler DI, Bjorksten AR, et al. Mild hypothermia alters propofol pharmacokinetics and increases the duration of action of atracurium[J]. Anesth Analg, 1995, 80:1007-1014. https://www.academia.edu/8413819/Mild_Hypothermia_Alters_Propofol_Pharmacokinetics_and_Increases_the_Duration_of_Action_of_Atracurium [5] Mahoney CB, Odom J. Maintaining intraoperative normothermia:a meta-analysis of outcomes with costs[J]. AANA J, 1999, 67:155-163. http://www.ncbi.nlm.nih.gov/pubmed/10488289 [6] Yi J, Xiang Z, Deng X, et al. Incidence of inadvertent intraoperative hypothermia and its risk factors in patients undergoing general anesthesia in Beijing:a prospective regional survey[J]. PLoS One, 2015, 10:e0136136. doi: 10.1371/journal.pone.0136136 [7] Yi J, Lei Y, Xu S, et al. Intraoperative hypothermia and its clinical outcomes in patients undergoing general anesthesia:national study in China[J]. PLoS One, 2017, 12:e0177221. doi: 10.1371/journal.pone.0177221 [8] Frank SM, Beattie C, Christopherson R, et al. Unintentional hypothermia is associated with postoperative myocardial ischemia. The Perioperative Ischemia Randomized Anesthesia Trial Study Group[J]. Anesthesiology, 1993, 78:468-476. doi: 10.1097/00000542-199303000-00010 [9] 唐佳, 李冬雪, 王志成.老年围术期低体温与感染的相关性研究[J].中华医院感染学杂志, 2015, 25:418-420. http://d.wanfangdata.com.cn/periodical/zhyygrxzz201502064 [10] 刘海元, 任远, 孙大为.妇科加速康复外科管理路径[J].协和医学杂志, 2018, 9:501-507. http://www.cnki.com.cn/Article/CJFDTotal-XHYX201806005.htm [11] 戴梦华, 王顺达, 刑骋, 等.加速康复外科理念在胰十二指肠切除术围手术期管理中的可行性[J].协和医学杂志, 2018, 9:533-538. http://www.cnki.com.cn/Article/CJFDTotal-XHYX201806009.htm [12] 蔡改革, 何龙, 张瑞珍, 等.围术期低体温及其防治进展[J].河南外科学杂志, 2018, 2:159-162. http://www.cnki.com.cn/Article/CJFDTotal-HLWK201802092.htm [13] Langham GE, Maheshwari A, Contrera K, et al. Noninva-sive temperature monitoring in postanesthesia care units[J]. Anesthesiology, 2009, 111:90-96. doi: 10.1097/ALN.0b013e3181a864ca [14] Robinson J, Charlton J, Seal R, et al. Oesophageal, rectal, axillary, tympanic and pulmonary artery temperatures during cardiac surgery[J].Can J Anaesth, 1998, 45:317-323. doi: 10.1007/BF03012021 [15] Pei L, Huang Y, Mao G, et al. Axillary temperature, as recorded by the iThermonitor WT701, well represents core temperature in adults having noncardiac surgery[J]. Anesth Analg, 2018, 3:833-838. [16] 滕晓菲, 张元亭.移动医疗:穿戴式医疗仪器的发展趋势[J].中国医疗器械杂志, 2006, 5:1671-1677. http://www.cnki.com.cn/Article/CJFDTotal-ZYLZ200605003.htm [17] 曹晓冬, 黄云娟, 黄琴红, 等.无线体温监测和位置跟踪传感器在ICU重症患者体温监测中的应用[J].护理学杂志, 2012, 2:53-55. http://d.wanfangdata.com.cn/Periodical/hlxzz201202026