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腹腔镜手术患者术中意外体温过低预防的最佳证据总结。

Summary of the best evidence for the prevention of intraoperative unplanned hypothermia in patients undergoing laparoscopic surgery.

作者信息

Wang Mindan, Jiang Yingying, Han Wenjuan, Jiang Ling, Mao Chenrong

机构信息

Operating Room, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.

Nursing Department, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Suzhou, China.

出版信息

Gland Surg. 2021 Sep;10(9):2790-2798. doi: 10.21037/gs-21-578.

Abstract

BACKGROUND

This study aimed to search, analyze, and summarize relevant evidence for the prevention of unplanned hypothermia in patients undergoing laparoscopic surgery, so as to reduce the incidence of unplanned hypothermia in patients undergoing laparoscopic surgery and provide a reference for clinical medical staff.

METHODS

According to the evidence pyramid model, relevant literature were retrieved by computer in databases. Literature quality evaluation and the evidence grading system of the Australian JBI Evidence-Based Health Care Centre Evidence Recommendation Rating System were used to evaluate the literature quality and determine the level of evidence. The time limit for retrieval was from the establishment of the databases to March 31, 2021.

RESULTS

A total of 12 studies were included in this study. Of these, 5 evidence items were finally extracted, and 15 pieces of best evidence were summarized, including the risk assessment of hypothermia in patients undergoing laparoscopic surgery, temperature monitoring, ambient temperature, passive insulation measures, and active insulation measures.

CONCLUSIONS

The evidence for the prevention of unplanned hypothermia in patients undergoing laparoscopic surgery provided evidence-based approaches for reducing the incidence of intraoperative hypothermia for clinical staffs. It is suggested that the cultural characteristics of China, medical resources, and patients' own conditions should be considered when applying the evidence.

摘要

背景

本研究旨在检索、分析和总结腹腔镜手术患者预防非计划性体温过低的相关证据,以降低腹腔镜手术患者非计划性体温过低的发生率,为临床医务人员提供参考。

方法

依据证据金字塔模型,通过计算机在数据库中检索相关文献。采用澳大利亚JBI循证卫生保健中心证据推荐分级系统的文献质量评价及证据分级系统对文献质量进行评价并确定证据级别。检索时限为各数据库建库至2021年3月31日。

结果

本研究共纳入12项研究。其中,最终提取5项证据条目,总结出15条最佳证据,包括腹腔镜手术患者体温过低的风险评估、体温监测、环境温度、被动保温措施和主动保温措施。

结论

腹腔镜手术患者预防非计划性体温过低的证据为临床工作人员降低术中体温过低的发生率提供了循证方法。建议在应用该证据时应考虑中国的文化特点、医疗资源及患者自身情况。

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本文引用的文献

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Risk factors for inadvertent intraoperative hypothermia in patients undergoing laparoscopic surgery: A prospective cohort study.
PLoS One. 2021 Sep 23;16(9):e0257816. doi: 10.1371/journal.pone.0257816. eCollection 2021.
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International expert consensus on laparoscopic pancreaticoduodenectomy.
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APSIC guidelines for the prevention of surgical site infections.
Antimicrob Resist Infect Control. 2019 Nov 12;8:174. doi: 10.1186/s13756-019-0638-8. eCollection 2019.
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Warmed, humidified CO insufflation benefits intraoperative core temperature during laparoscopic surgery: A meta-analysis.
Asian J Endosc Surg. 2017 May;10(2):128-136. doi: 10.1111/ases.12350. Epub 2016 Dec 14.
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Intravenous nutrients for preventing inadvertent perioperative hypothermia in adults.
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