术中保温护理对人工髋关节置换术患者凝血功能及术后苏醒的影响

Effects of Intraoperative Heat-preservation Nursing on the Blood Coagulation Function and Postoperative Palinesthesia in Patients with Total Knee Prosthesis Replacement

目的:探讨术中采用保温护理对人工髋关节置换术患者凝血功能及术后苏醒的影响,降低手术风险。方法:将60例患者随机分为观察组30例和对照组30例,均给予常规护理措施,观察组加用保温护理,观察记录两组术中输液量、出血量及手术时间,围术期低体温发生率,术后复苏情况及凝血功能等。结果:观察组术中输液量、出血量和手术时间与对照组相似,差异无统计学意义(P>0.05)。观察组低体温发生率6.67%、寒战发生率6.67%,对照组低体温发生率33.33%、寒战发生率46.67%,差异有统计学意义(P>0.05)。观察组气管拔管时间、完全清醒时间和麻醉恢复室滞留时间均短于对照组,差异有统计学意义(P>0.05)。手术前,两组患者凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)指标检测结果相似,差异无统计学意义(P>0.05);手术结束时观察组PT、TT、APTT和FIB指标检测结果与手术前相似,差异无统计学意义(P>0.05),而对照组与手术前比较变化显著,差异有统计学意义(P>0.05)。结论:保温护理可以有效降低人工髋关节置换术患者低体温及寒战发生率,促进麻醉复苏,提高苏醒质量,保护凝血功能。

Objective： To investigate the effects of intraoperative heat-preservation nursing on the blood coagulation function and postoperative palinesthesia in patients with total knee prosthesis replacement,and to reduce the operative risks. Method： A total of 60 patients were randomly divided into observation group and control group,with 30 patients in each group. All the patients were given with usual care,but the observation group given with heat-preservation nursing additionally,and the intraoperative volumes of fluid infused,blood losses,operative times,perioperative hypothermia incidences,postoperative palinesthesia conditions,and blood coagulation functions and so on in the patients of the two groups were observed and recorded. Result： The observation group had similar intraoperative volume of fluid infused,blood loss,and operative time to the control group,and the differences were statistically insignificant（ P 0.05）. The incidences of hypothermia and rigor of the observation group were 6.67%,respectively,while those of the control group were33.33% and 46.67%,respectively,and the differences were statistically significant（ P 0.05）. The observation group had shorter times to tracheal extubation and complete alertness,and time of stay in the anesthetic recovery room than the control group,and the differences were statistically significant（ P 0.05）. Before the operation,the patients of the two groups had similar prothrombin time（ PT）,thrombin time（ TT）,activated partial thromboplastin time（ APTT）,and fibrinogen（ FIB） results,and the differences were statistically insignificant（ P 0.05）; at the end of the operation,the observation group had similar PT,TT,APTT,and FIB results to those before the operation,and the differences were statistically insignificant（ P 0.05）,but the control group had significantly changed PT,TT,APTT,and FIB results,and the differences were statistically significant（ P 0.05）.Conclusion： Heat-preservation nursing can effectively reduce the incidences of hypothermia and rigor,promote postanaesthetic recovery,elevate palinesthesia quality,and protect blood coagulation function in patients with total knee prosthesis replacement.