Effect of perioperative thermal preservation on hemostatic function in elderly patients

Abstract

Objective To research the effect of perioperative thermal preservation on hemostatic function in elderly patients.Methods 60 elderly patients undergone the radical laparoscopic rectal cancer resection,with ASA Ⅰ-Ⅱ,were randomly divided into two groups,each group was thirty patients.Control group (group Ⅰ) was routine operation,experimental group (group Ⅱ) was comprehensively heat preservation.To monitor and record respectively the nose pharynx temperature of each group patients in preanesthesia,30,60,90,120 min post-anesthesia and after operations.To abstract peripheral blood from the elderly patients and measure prothrombin time(PT),activated partialthromboplastin time(APTT),thrombin time(TT),platelets (PLT),D-dimer(DD),fibrinogen(FBG),von willebrand factor(vWF) levels in pro-anesthesia,30,60,90,120 min intraoperations,post-operation,and 24,48,72,120 h post-operation.Results The temperature in group Ⅰ (℃)[(36.52±0.08),(36.22±0.07),(35.83±0.07),(35.68±0.06)and (35.65±0.06)] was lower than that in pro-anesthesia (36.86±0.08) ℃ and that in the same time in group Ⅱ (℃)[ (36.83±0.12),(36.80±0.10),(36.78±0.11),(36.76±0.10) and (36.80±0.11)] in 30,60,90,120 min post-anesthesia and post-operations(P＜0.05).The levels of PT(s)[ (16.12±0.31),(16.32±0.51),(16.21±0.33),(16.32±0.42)and (16.32±0.32)],APTT(s)[(39.3±3.3),(39.2±3.2),(42.2±3.1 ),(434±3.2) and (44.4±3.3)] and TT(s)[ (16.2±1.0),( 16.3±1.1 ),(17.1±1.4),(17.3±1.4) and (18.3±1.4) ] in group Ⅰ were significantly longer than that PT( 14.12±0.21 ) s,APTT(34.3±1.5) s and TT(14.1±0.5) s in pre-anesthesia and that PT (s)[(13.32±0.23),(13.42±0.21),(13.32±0.22),(13.42±0.31),(14.21±0.12)],APTT(s)[(35.3+1.4),(35.2+1.3),(34.2+1.4),(34.2±1.4),(34.1±1.3)] and TT(s)[(14.0±0.4),(14.4±0.3),(14.2±0.4),(14.2±0.5),(14.0±0.4)] in the same time in group Ⅱin 30,60,90,120 min intaoperations and post-operations (P＜0.05).The levels of PLT(×109/L)[(178±13),(121±15),(131±34),(123±35),(166±14)] in group Ⅰ were obviously lower than that in pro-anesthesia (213±12)×109/L and that PLT(×109/L)[ (209±14),( 192±13 ),(198±17),(203±18),(216±15) ] in the same time in group Ⅱ in 120 min intraoperations,post-operations and 24,48,72h post-operations(P＜0.05).The levels of DD(mg/L)[(1.01±0.11),(0.82±0.13),(0.71±0.12)] and vWF(％ )[ (220±23),(183±20),(126±18)] were markedly higher than that DD (0.41±0.12) mg/L and vWF (92+12)％ in pro-anesthesia and that DD(mg/L)[(0.44±0.12),(0.45±0.22),(0.45±0.21)] and vWF(％)[(94+12),(96±13),(95±11)] in the same time in groupⅡ in 24,48,72 h post-operation ( P＜0.01 ),but the levels of FBG (％) [ ( 1.5 ±0.3 ),( 1.6±0.3 ),(2.1±0.3) ] were distinctly lower than that FBG (2.5±0.3)％ in pro-anesthesia and group Ⅱ (％)[(2.5±0.4),(2.5±0.4),(2.5±0.5)] in the same time(P＜0.05).Conclusions The perioperative comprehensive heat preservation can partly alleviate hemostatic function suppression in elderly patients after operations and make them early recovery. Key words: Perioperative; Therma1 preservation; Elderly patient; Hemostatic function