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手術時有沒有保溫,對凝血的影響
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plasticsuper
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註冊時間: 2005-08-04
文章: 623
來自: 台北

發表 發表於: 星期四 八月 25, 2005 7:38 pm
發表 文章主題: 手術時有沒有保溫,對凝血的影響
引言回覆

據這篇文章指出,沒有保溫的病人体溫會差2度左右
對PT沒有影響,但對pTT及 bleeding time 則會增長

總之,有保溫的病人凝血功能會比較正常

Title Effects of Mild Hypothermia on Blood Coagulation in Patients Undergoing Elective Plastic Surgery.

Source Plastic & Reconstructive Surgery. 116(1):316-321, July 2005.

Abstract Background: The aim of this prospective, controlled study was to evaluate the effects on coagulation function of active patient warming during elective plastic surgery.

Methods: Seventy-six patients undergoing elective plastic surgery (additive and reductive mastoplasty, rhinoplasty, and liposuction) were either covered with standard sterile drapes (control group, n = 38) or actively warmed during surgery with countercurrent fluid warming and forced-air skin warming (treatment group, n = 38). Complete evaluation of the coagulation activity was performed 1 hour before general anesthesia was induced and then at the end of surgery.

Results: Although no differences in preoperative core temperature were observed (36.0 +/- 0.5[degrees]C in the control group and 36.1 +/- 0.4[degrees]C in the treatment group; p = 0.12), core temperature was lower at the end of surgery in the control group (34 +/- 1.0[degrees]C) than in the treatment group (36 +/- 0.6[degrees]C) (p = 0.0005). No differences in prothrombin time and fibrinogen plasma concentrations were observed between the two groups. At the end of surgery, control group patients showed significantly larger activated partial thromboplastin times (36.8 +/- 3.5 seconds) and bleeding times (8.1 +/- 1.6 minutes) as compared with patients maintained normothermic during surgery (34.0 +/- 2.9 seconds and 4.3 +/- 1.1 minutes; p = 0.0005 and p = 0.0005, respectively).

Conclusion: Actively maintaining intraoperative normothermia allows patients to maintain normal coagulation function during elective plastic surgery lasting longer than 2 hours, potentially reducing the occurrence of bleeding-related complications after plastic surgery.

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