主动体温保护对下肢骨折手术凝血功能及出血的影响

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Abstract Objective To observe the effect of active temperature protection on the coagulation function and the change of blood volume in patients with lower limb fracture. Methods 80 cases of ASA Ⅰ~Ⅱ patients with lower limb fractures and open reduction were randomly divided into the active temperature protection group and the control group.The room temperature wass set to 26° when temperature protection groups entered into the operating room，and the temperature had been reset to 22°till surgery starts.3M inflatable thermal insulation blankets covered their chest and the target body temperature was set to 38℃.The blankets were separated from the skin of the patients.Intravenous fluids temperature was 37℃，and rinse fluid temperature was also 37℃.The control group patients were covered with the surgical towel sheet，with room temperature being set to 22℃；thermal blankets were not used，and room temperature liquid were used for infusion and rinse.Auricular temperature of two groups of patients were recorded in the operating room(T1)，tangent(T2)，1h(T3)after the surgery，1h(T4)after the operation.And venous thrombosis were respectively measured.Intraoperative blood loss and 36h drainage were recorded，and the amountr of blood transfusions was recorded.Results a)Compared with the body temperature protection group，the ear temperature of the control group was significantly lower than the active body temperature protection group during operation T4，and the difference was statistically significant(P＜0.05)b)The blooding volume in the active body temperature protection group and drainage volume were lower than those in the control group(P＜0.05)；c)Compared with the body temperature protection group，T3 and T4 were significantly prolonged in the formation of fibroin protein and the time of the formation of blood clots.The maximum amplitude of the control group was significantly shortened in T4，which presents statistical significance.(P＜0.05).Conclusion Low temperature can induce inhibition of blood coagulation factor activity and platelet function in the orthopaedic patients with fracture of lower limb during the intraoperative and postoperative process，which leads to increased blood loss and flow rate as well as an increase in the probability of blood transfusion.Active temperature protection can reduce the body heat loss，decrease fibrinolysis and reduce the blood loss in patients with lower extremity fracture.

Key words： body temperature control lower extremity fracture coagulation blood lose

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