腹腔镜直肠癌术中低体温相关因素分析与护理

Analysis of relevant factors and nursing for hypothermia caused by laparoscopy-assisted operation for colorectal cancer

目的:对行腹腔镜直肠癌手术过程中诱发低体温的具体因素进行探究,并就术中低体温影响因素提出相应对策。方法:择取过去一年2016年4月~2017年3月于我院接受腹腔镜直肠癌手术治疗的184例直肠癌病患进行回顾分析。依据每位直肠癌病患术中体温界限的不同将其分为体温小于36℃的低温组104例与体温不低于36℃且不高于38℃的常温对照组80例,对腹腔镜直肠癌术中诱发低温的危险因素进行总结分析,并提出有效的护理对策。结果:对照组对比分析发现,手术时间、麻醉时间、失血量、CO_2用量以及术中补液量、冲洗液用量是造成腹腔镜直肠癌术中低温的单因素诱因,而进一步行logistic多因素分析发现术中CO_2用量在200 L以上、麻醉时间在3 h以上以及补液量在1500 ml是造成低体温最为主要的危险因素。结论:行腹腔镜直肠癌手术患者其术中麻醉时间、补液以及CO_2用量过度是造成直肠癌患者低体温最为主要的危险因素,医护人员应格外注意上述因素,对于已出现低体温症状患者则应加强体温监测、气腹加温以及物理保温等形式来缓解低体温症状。

Objective: To investigate concrete factors that inducing hypothermia during laparoscopy-assisted operation for colorectal cancer and propose corresponding countermeasures for influence factors related to hypothermia in operation. Methods: To select 184 cases of colorectal cancer patients treated by laparoscopy-assisted operation in our hospital in the last year from April 2016 to March 2017,and apply retrospective analysis. According to different temperature limit during operation for each colorectal cancer patient,divide them into low temperature group of 104 cases whose temperature is less than 36℃and normal temperature control group of 80 cases whose temperature is not lower than 36℃ and not higher than 38℃. Summarize and analyze dangerous factors inducing hypothermia during laparoscopy-assisted operation for colorectal cancer and raise effective nursing countermeasures. Results: Compare and analyze patients in control group,operation time,anesthesia time,blood loss volume,CO_2 dosage,fluid infusion volume and flushing fluid volume during operation was the single-factor inducement for low temperature during laparoscopy-assisted operation for colorectal cancer. Further by logistic multi-factor analysis,it indicated that CO_2 dosage above 200 L,anesthesia time exceeding 3 h and 1500 ml fluid infusion were the most dangerous risks for hypothermia. Conclusion: Anesthesia time,fluid infusion,CO_2 excessive dosage are the most dangerous risks for hypothermia of colorectal cancer patients during laparoscopy-assisted operation for colorectal cancer,so medical nurses should pay more attention to above-mentioned factors and for patients with hypothermia,medical nurses shall strengthen temperature surveillance,and apply pneumoperitoneum warming and temperature keeping through physical method to alleviate hypothermia symptom.