保温干预联合疼痛管理对胃癌手术患者疼痛、体温及血流动力学的影响

Effect of thermal insulation intervention combined with pain management on pain,body temperature and hemodynamics in patients undergoing surgery for gastric cancer

目的探讨保温干预联合疼痛管理对胃癌手术患者疼痛、体温及血流动力学的影响。方法根据干预方式的不同将86例胃癌手术患者分为对照组(n=42)和观察组(n=44),对照组患者采取常规干预,观察组患者在对照组的基础上采取保温干预联合疼痛管理。比较两组患者的疼痛相关指标[数字分级评分法(NRS)、患者自控镇痛(PCA)泵按压次数及舒芬太尼追加剂量]、体温、血流动力学指标[心率(HR)、脉搏血氧饱和度(SpO2)]、低体温情况及躁动情况。结果术后4、12 h,观察组患者NRS评分均明显低于对照组,差异均有统计学意义(P﹤0.01);观察组患者PCA泵按压次数及舒芬太尼追加剂量均明显少于对照组,差异均有统计学意义(P﹤0.01)。手术1 h、手术2 h及术毕,观察组患者体温均明显高于对照组,差异均有统计学意义(P﹤0.01)。术后4 h,两组患者HR均高于本组术前,观察组患者HR低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者低体温、躁动发生率均低于对照组,差异均有统计学意义(P﹤0.05)。结论保温干预联合疼痛管理可减少胃癌手术患者的镇痛药物使用量,减轻术后疼痛,减少热量流失,维持术中血流动力学稳定,降低低体温及躁动发生风险。

Objective To explore the effect of thermal insulation intervention combined with pain management on pain,body temperature and hemodynamics in patients undergoing surgery for gastric cancer.Method According to the different intervention methods,86 patients with gastric cancer surgery were divided into control group(n=42)and observation group(n=44).Patients in the control group received routine intervention,and patients in the observation group received thermal insulation intervention combined with pain management on the basis of the control group.The pain-related indexes[numerical rating scale(NRS),patient controlled analgesia(PCA)pump compressions and additional sufentanil dose],body temperature,hemodynamic indexes[heart rate(HR),pulse oxygen saturation(SpO2)],hypothermia and agitation were compared between the two groups.Result At 4 and 12 h after operation,the NRS scores in observation group were significantly lower than those in control group,and the differences were statistically significant(P<0.01).The times of PCA pump compress and the additional dose of sufentanil in observation group were significantly lower than those in control group,and the differences were statistically significant(P<0.01).At 1 and 2 h after the start of the operation and immediately after the operation,the body temperatures in observation group were significantly higher than those in control group,and the differences were statistically significant(P<0.01).At 4 h after surgery,the HR in both groups were higher than those before surgery,and the HR in observation group was lower than that in control group,and the differences were statistically significant(P<0.05).The incidence of hypothermia and agitation in observation group were lower than those in control group,and the differences were statistically significant(P<0.05).Conclusion Thermal insulation intervention combined with pain management can reduce the amount of analgesic drugs used in patients undergoing gastric cancer surgery,alleviate postoperative pain,reduce heat loss,maintain stable intraoperative hemodynamics,and reduce the risk of hypothermia and agitation.