护理干预对等离子体前列腺电切术中病人体温的影响

The Clinic Research of the Effect of Nurse intervention on the Perioperative Body Temperature in Patients Undergoing TUPKRP

目的 探讨不同的护理干预措施对经尿道前列腺等离子体双极汽化电切术（TUPKRP）病人术中体温保护的作用和效果。方法 57例ASAⅠ-Ⅱ，将拟行TUPKRP病人，随机分为三组（n=19），A组为室温组；B组为加温输液组；C组为加温膀胱冲洗液组。维持手术间温度22℃。麻醉后将肛温探头从肛门插入约15cm至乙状结肠，以测量深部体温。记录手术开始前体温作为基础体温，手术开始后每隔15min记录一次体温，最后一次体温作为术终体温。记录术中寒战反应发生情况及手术时间及冲洗液总量，计算冲洗速度。结果对照观察各组输液速度及基础体温无显著性差异。A组体温下降速度和幅度较B、C组明显，而B、C两组比较无差异。A组术终体温较基础体温降低1．2℃（P〈0．01），B、C两组则分别降低0．3℃、0．4℃。A组5例病人出现寒战，B组有1例，C组有2例，A组与B、C组比较有显著性差异（P〈0．01）。但B与C两组间无差异。结论 加温输液和加温膀胱冲洗液均可有效保持TUPKRP病人术中体温恒定，防止术中体温降低和热量丢失，减少不良反应的发生。

Objective To observe the effect of different intervening measures on keeping the body temperature during perioperative period in patients undergoing TUPKRP. Methods 57 patients with ASA physical status Ⅰ and Ⅱ scale undergoing elective TUPKRP were randomly divided into three groups, 19 cases in each group, which consist of room temperature group （group A）, intravenous warm liquid infusion group（ group B） and warm liquid rinsing bladder group（ group C）. Keep the operation room＇s temperature at 22℃ in all groups. After being anaesthetized, all patients were inserted a temperature probe from anus to sigmoid colon to measure the central body temperature. Results There were no significant difference in intravenous infusion tempo and basic body temperature among the three groups. The body temperature decreasing speed and range in group B and C were much more obvious than that of group A, but there were no difference between group B and C. the body temperature In group A reduced by 1.2℃ at the end of operation in comparison to that of preoperation （ P 〈0.01 ）, and it reduced by 0.3℃ in group B, 0.4℃ in group C, respectively. 5 patients in group A appeared cold and shivering, and 1 case in Group B, 2 cases in group C, respectively. Compared with B and C group, patients in Group A had a higher incidence of shivering （ P 〈 0.01 ）, but there was no difference between group B and group C. Conclusion We conclude that intravenous warm liquid infusion and rinsing bladder with warm liquid have the ability to keep body temperature invariable in patients undergoing TUPKRP, furthermore it could protect against heat quantity losing and reduce the incidence of side effect.