氨基酸联合加温灌注护理在老年患者经尿道前列腺电切术中的意义

The meaning of hyperthermia perfusion nursing with amino acid combined in the transurethral resection of prostate of perioperative period about older patients

目的:探讨氨基酸联合加温灌注护理在老年患者经尿道前列腺电切术(TURP)围术期中的意义。方法:选择90例老年(≥70岁)良性前列腺增生症接受TURP患者,随机分为3组,每组30例。对照组采用常规护理方法;加温灌注组(加温组)在对照组的基础上,静脉输液使用37℃的液体配合静脉输液加温器(37℃),术中与术后的膀胱冲洗液均加热至术前鼻咽部温度再冲洗;氨基酸联合加温灌注组(联合组)在加温组的基础上,术前1h输注支链氨基酸3.5ml/kg。监测3组患者术前1h、手术1h、术毕时、术后8h的鼻咽部体温,记录3组患者围术期寒颤及膀胱痉挛的发生率,发放护理满意度调查表并记录。结果:手术1h、术毕时、术后8h加温组及联合组患者体温均高于对照组(P<0.05),而在手术1h、术毕时联合组患者体温高于加温组(P<0.05),围术期寒颤及膀胱痉挛发生率对照组均高于加温组及联合组(P<0.05),但加温组寒颤发生率也高于联合组(P<0.05),护理满意度对照组低于加温组及联合组(P<0.05)。结论:氨基酸联合加温灌注护理在老年患者TURP围术期中更能保持患者核心温度,减少低温寒颤与膀胱痉挛的发生,避免诱发或加重老年患者的合并症,提高了患者的护理满意度。

[ Objective]to discuss the meaning of hyperthermia perfusion nursing with amino acid combined in the transurethral resection of prostate（TURP）of perioperative period about older patients. [Method] 90 patients who chose TURP（ ≥ 70 years old）are divided into 3 groups at random,30 each. The control group adopted routine methods including using epidural analgesia pumpafter in the surgery. Based on this, heating perfusion group（heating group）used intravenous infusion with 37℃ fluid as well as intravenous infusion warmer. Bladder washings was used in and after the surgery are wanned till the temperature of preoperative nasopharyngeal. Based on heating group, hyperthermia perfusion nursing with amino acid combined（Joint Group）injected the branched chain amino acids 3.5ml/kg one hour before the surgery. Monitor the nasopharyngeal temperature of patients one hour before the surgery, during the the surgery, at the end of the surgery and eight hours after the surgery, record the chills of perioperative and the incidence of bladder spasm, distribute questionnaire of satisfaction with nursing and record. [ Result ]During the the surgery, at the end of the surgery and eight hours after the surgery, the body temperatures of patients of heating group and Joint Group are higher than the control group（ P 〈 0.05）.During and at the end of the surgery,the body temperatures of patients of Joint Group are higher than heating group（ P 〈 0.05）. Perioperative chills and the incidence of bladder spasroof the control group is higher than heating group and Joint Group（ P 〈0.05）. The incidence of chills of the heating group is higher than Joint Group（ P 〈 0.05）. In terms of satisfaction with nursing,the control group is lower than heating group and Joint Group. [ Conclusion] hyperthermia perfusion nursing with amino acid combined can maintain core temperature of the patients,reduce the occurance of low body temperature and chilis. It further reduces the incidence of bladder spasm and prevents or reduces complications of old patients. It can also raise satisfaction with nursing .