系统保温护理对腹腔镜下子宫肌瘤切除患者的体温及凝血功能的影响

Study on the effect of nursing on the body temperature and coagulation function of patients with laparoscopic hysteromyomectomy

目的:探讨系统保温护理对腹腔镜下子宫肌瘤切除患者的体温及凝血功能的影响。方法:选择我院行择期腹腔镜下子宫肌瘤切除患者86例为研究对象,随机分为观察组43例,对照组43例。对照组患者术中行常规护理干预,观察组术中采用系统保温护理,记录并比较两组患者入室(入室后10 min)、术中(手术30 min)、术毕(放气后5 min)体温(T),及凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)等凝血指标,及收缩压(SBp)、舒张压(DBp)、心率(HR)及术后麻醉苏醒时间、苏醒后寒战等发生情况。结果:观察组患者低体温、寒战发生率低于对照组(P<0.05);观察组患者术后麻醉苏醒时间小于对照组(P<0.05)。观察组患者术中及术毕体温均高于对照组(P<0.05)。观察组术毕SBp、DBp、HR均低于对照组(P<0.05)。两组患者PT、TT、APTT术毕均延长,对照组术毕PT、TT、APTT与入室比较,差异有统计学意义(P<0.05);与观察组同期比较,差异有统计学意义(P<0.05)。结论:围术期采取系统保温护理对腹腔镜下子宫肌瘤切除术在术前、术中、术后进行相应的保温护理干预,可有效预防低体温的发生,减少机体热量散失,从而维持患者围术期体温相对恒定,保障机体血流动力学稳定,有效缩短麻醉苏醒时间,减少术后并发症,对患者围术期及预后有重要意义。

Objective： To investigate the effect of thermal insulation nursing on the body temperature and coagulation function of patients with laparoscopic myomectomy. Methods： 86 cases of laparoscopic hysteromyomectomy were randomly divided into observation group（n =43） and control group（n =43）. Patients in the control group received routine nursing intervention, and the patients of observation group were treated with system insulation nursing intervention. The body temperature（T）, prothrombin time（PT）, thrombin time（TT）,activated partial thromboplastin time（APTT）, systolic blood pressure（SBp）, diastolic blood pressure（DBp）, heart rate（HR）, anesthesia awakening time, and the occurrence of chills in the two groups were recorded and compared at 10 minutes after entering the operation room, 30 minutes during operation, and finishing time of operation. Results： The incidence rates of low temperature, chills and postoperative recovery time in the observation group were significantly lower than those in the control group. Temperature in the observation group was higher than that in the control group during and finishing operation（P 0.05）. SBp, DBp and HR were increased in the two groups at finishing time of operation（P0.05）. And they were lower than those of the control group（P0.05）. Two groups of patients with PT, TT,APTT were extended. At finishing time of operation, PT, TT and APTT of the control group were different with the time of entering room and at the same time of observation group（P0.05）.Conclusion： System insulation nursing can effectively prevent the occurrence of low temperature and reduce heat loss. It can maintain the patient ＇s body temperature relatively constant in perioperative period, ensure the stability of hemodynamics, shorten the recovery time, and reduce postoperative complications. It has important significance to the perioperative period and prognosis of patients.