心脏手术可在患者自身温度下进行无需主动降温
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Open Heart Surgery at Patient's Own Temperature Without Active Cooling
背景与目的
低温是心脏手术中心肌保护的一种方法。这种保护是通过减少代谢需求来实现的，然而，它会引起各种敏感问题。在这项研究中，我们研究了在常温（在患者自身体温下）和低温下手术的患者术后差异。
方 法
该研究于2015年6月至2016年9月期间进行，共有167名患者。根据我们的临床常规将患者分为两组：常温组（自然温度组;术中体温≥34°C），低温组术中体温<34°C - ≥28°C）。记录患者的术前和术后数据，并对两组进行比较。
结 果
两组在阻断时间、体外循环时间、苏醒和拔管时间、重症监护病房和住院时间、引流量、平均血清乳酸水平、心律失常、所有感染原因、肾功能不全、神经系统并发症方面无显着差异。心肌梗死或死亡率（P> .05）。发现强心药和输血需要量在常温组明显低于低温组有统计学意义（P <.05）。
结 论
虽然低温常用于心脏手术，但它有不良影响。我们相信心脏手术可以安全地在患者自身的温度下进行，无需主动降温以避免这些不良影响。
原始文献摘要
BACKGROUND
Hypothermia is a method of myocardial protection in cardiac surgery. This protection occurs by decreasing the metabolic demands, however, it creates susceptibility to various problems. In this study, we investigated patients operated on under normothermia (at the patient's own temperature) and hypothermia for postoperative differences.
METHODS The study was conducted between June 2015 and September 2016 with 167 patients. The patients were divided into two groups in accordance with our routine clinical practice: the normothermic group (native temperature goup; intraoperative body temperature ≥ 34°C), and the hypothermic group intraoperative body temperature < 34°C - ≥ 28°C). Preoperative and postoperative data of patients were recorded and the two groups were compared.
RESULTS
There was no significant difference between the two groups in terms of cross clamp time, cardiopulmonary bypass time, awakening and extubation times, intensive care unit and hospital stay, drainage, mean serum lactate levels, arrhytmia, all causes infection, renal insufficiency, neurologic complications, myocardial infarction, or mortality (P > .05). Inotrope and transfusion requirements were found to be statistically significantly lower in the normothermic group than the hypothermic group (P < .05).
CONCLUSION
Although hypothermia is commonly used in cardiac surgery, it has harmful effects. We believe that cardiac surgery can safely be performed at a patient's own temperature without active cooling to avoid these dangers.
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贵州医科大学高鸿教授课题组
编辑：代东君 审校：符校魁