全身麻酔中の体温低下防止に関する臨床的研究

预防全身麻醉过程中体温过低的临床研究

• 批准号: 09771761
• 负责人: 寶田 貫
• 金额: $ 1.34万
• 依托单位: Hiroshima University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Encouragement of Young Scientists (A)
• 财政年份: 1997
• 资助国家: 日本
• 起止时间: 1997 至 1998
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-09771761/
• 关键词: 全身麻酔; 術中低体温; レーザードプラー血流計; 体温調節性血管収縮; 再分布性低体温

全身麻酔を受ける患者の80%が術中低体温になるといわれている。この術中の体温低下は,同様のパターンをとることが多いと報告されている。すなわち,麻酔導入後最初の1時間で中枢温は0.5〜1.5℃急速に低下,その後の2〜3時間で徐々に低下,それ以降は体温低下は停止し安定する。今回,口腔外科手術患者の体温変動を観察し,定説とは若干異なる結果を得た。[結果]1. 末梢温,末梢血流量は麻酔導入直後より急上昇し,以後大きな変化を示さなかった。2. 中枢温は導入直後より低下した(1.0±0.4℃)。しかし31.4±5.5分後に低下は停止し、以後上昇した。その経時的変化に有意差を認めた。3. 平均皮膚温は導入直後より低下した(0.5±0.3℃)。しかし17.0±7.8分後に低下は停止し,以後上昇した。その経時的変化に有意差を認めた。4. 全症例において,平均皮膚温の再上昇が中枢温の再上昇に先行した。[考察]麻酔導入直後の中枢温の低下は,麻酔薬により末梢血管が拡張し,中枢の熱が冷えている末梢組織へ移動するためと考えられており,本研究結果もこれに矛盾しない。しかし本研究では,中枢温低下は早期に停止し上昇した。平均皮膚温も導入直後低下したが,中枢温よりも先んじて再上昇を開始した。平均皮膚温の低下は,麻酔導入時に身体が低温環境に暴露したため,再上昇は導入後の適切な保温により,中枢から移動した熱の体表からの損失を押さえたためと考えられる。これが中枢温低下の早期停止および復温につながったと考察した。

Patients with general anaesthesia are suffering from 80% moderate hypothermia and mild hypothermia. If you have hypothermia in the art, please tell me that you are suffering from hypothermia. The central temperature dropped rapidly at 0.5-1.5 ℃ at the first time after the introduction of the anaesthesia, and gradually decreased at 2-3 hours after the onset of anesthesia. This time, oral surgery patients underwent body temperature exercise examination, and a number of test results were confirmed. [results] 1. The temperature of the end, the blood flow of the end, the temperature of the end, the blood flow of the end, the temperature of the end, the temperature of the end, the blood flow of the end, the temperature of the end, the temperature of the end, the blood flow of the end. two。 The temperature in the central nervous system was lowered to low temperature (1.0 ±0.4 ℃). The score was 31.4 ±5.5, then the low level was stopped, and the next was the last one. When you are busy, you will intentionally make a difference in your recognition. 3. The average temperature of the skin was lower than that of the control group (0.5 ±0.3 ℃). The score was 17.0 ±7.8, and the lower score was 17.0 ±7.8, and then the lower score was 17.0 ±7.8, and then the lower score was 17.0 ±7.8. When you are busy, you will intentionally make a difference in your recognition. 4. In all cases, the average temperature of the skin, the temperature of the center, the temperature of the center, the temperature of the skin, the temperature of the center, the temperature of the center and the temperature of the center. [investigation] after the onset of anesthesia, the central temperature was low, the peripheral blood vessels were affected, and the central nervous system was used to transfer the tissue tissue. The results of this study were contradictory. In this study, hypothermia in the central nervous system was stopped in the early stage. The average temperature of the skin is lower than the average temperature of the skin, and the temperature of the central temperature is lower than that of the central temperature, and the average temperature of the skin is low. The average temperature of the skin is low, and the body is exposed to low temperature environment during anesthesia. After loading, the heat preservation temperature is cut, and the central motor is moved to the body surface of the vehicle. The central hypothermia should be stopped in the early stage.

项目成果

寶田貫: "口腔外科手術患者の術中体温変動について" 日本歯科麻酔学会雑誌. 26・4. 626 (1998)

N. Takara：“口腔手术患者的术中体温波动”日本牙科麻醉学会杂志 26, 4. 626 (1998)。