中文摘要：

目的 探讨二氧化碳加温对妇科腹腔镜手术患者围手术期体温及应激反应的影响,并提出相应的护理对策。方法 将60例行腹腔镜下广泛全子宫切除＋盆腔淋巴清扫术的患者随机分为加温组（30例）和对照组（30例）,记录两组术前、术中和术后的体温、肾上腺素和去甲肾上腺素的变化情况,以及术后寒战发生率和麻醉复苏时间,并进行比较。结果 加温组患者从手术开始后60 min至术后3 h的体温均高于对照组,两组体温差异有统计学意义（P〈0.05）。术后寒战发生率分别为加温组23.33%和对照组73.33%,麻醉复苏时间分别为加温组（11.70±3.10）min以及对照组（14.73±3.70）min,两组间的差异均有统计学意义（P〈0.05）。两组气腹后的肾上腺素和去甲肾上腺素浓度均比气腹前有所升高,但加温组升高的幅度明显小于对照组（P〈0.05）。结论 妇科腹腔镜手术中使用二氧化碳加温,可明显降低围手术期低体温和术后寒战的发生率,减轻术中应激反应,缩短术后麻醉的复苏时间。

英文摘要：

Objective To investigate the effect of pneumoperitoneum with carbon dioxide warming on body temperature and stress response of perioperative period in patients undergoing gynecological laparoseopic surgery, and to provide corresponding nursing strategy. Methods 60 patients undergoing laparoseopic radical hysterectomy and pelvic lymphadenectomy were randomly divided into warming group （ 30 cases） and control group （ 30 cases）. The changes of body temperature, adrenaline （AD） and norepinephrine （NE） during perioperative period, the in- cidence of postoperative shivering, as well the anesthesia recovery time were recorded and compared between the two groups. Results The body temperatures from 60min after the beginning of the operation to 3h after operation in the warming group were higher than the control group （P〈0.05）. The postoperative shivering rate were 23.33% in the warming group and 73.33% in the control group, the recovery time af- ter anesthesia were （11.70±3.10） min in the warming group and （14.73±3.70） min in the control group, there was statistical significance be- tween the two groups（ P〈0.05 ） , respectively. The concentrations of AD and NE after pneumoperitoneum were increased than those before pneumoperitoneum, but those of warming group were increased obviously smaller than control group （P〈 0.05 ）. Conclusion The usage of carbon dioxide wanning in gynecological laparoscopic surgery could significantly reduce the incidence of low body temperature perioperative period and the postoperative shivering rate, lessen the intraoperative stress response, and shorten the recovery time after anesthesia.