甲状腺肿瘤患者全麻手术中的保温护理及对不良反应的影响

Thermal insulation nursing and the effect on adverse reactions in patients undergoing surgery for thyroid tumors under general anesthesia

目的探讨甲状腺肿瘤患者全麻手术中的保温护理及对不良反应的影响。方法选取2015年5月至2017年5月间南京江北人民医院收治的60例甲状腺肿瘤全麻手术患者,采用单盲法随机分为研究组和对照组,每组30例。研究组患者采用常规护理联合保温护理,对照组患者采用常规护理,比较两组患者手术相关指标、应激反应及麻醉恢复评分。结果两组患者手术相关指标比较,差异无统计学意义(P>0.05)。研究组患者低体温、寒战和躁动发生率均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者肾上腺素(AD)、去甲肾上腺素(NE)及C反应蛋白(CRP)均明显低于对照组,差异均有统计学意义(均P<0.05)。两组患者出室时,麻醉恢复评分均比入室时升高,且研究组患者血压和总评分明显高于对照组患者,差异均有统计学意义(均P<0.05)。结论保温护理可减少甲状腺肿瘤患者全麻术后低体温、寒战及躁动发生率,减轻应激反应,维持血压平衡,具有临床推广价值。

Objective To investigate thermal insulation nursing and the effect on adverse reactions in patients undergoing surgery for thyroid tumors under general anesthesia. Methods Sixty patients with thyroid tumors who underwent surgery under general anesthesia at Nanjing Jiangbei People＇s Hospital from May 2015 to May 2017 were selected and randomly divided into an observation group and a control group using single blind method with 30 patients in each group. The observation group was given thermal insulation nursing and the control group was given routine care. Clinical indicators,stress response and anesthesia recovery score were compared between the two groups. Results There was no significant difference in surgery related indexes（P〉0. 05）. The incidence of low body temperature,chills and restlessness was lower in the observation group than in the control group（P〈0. 05）. The adrenaline epinephrine（AD）,norepinephrine（NE） and C-reactive protein（CRP） levels were significantly lower in the observation group than in the control group（all P〈0. 05）. The scores of anesthesia recovery in both groups increased out of the surgery room and blood pressure and overall score were significantly higher in the study group than in the control group（all P〈0. 05）. Conclusion Thermal insulation care can reduce the incidence of hypothermia,chills,restlessness and stress response and maintain blood pressure balance which has clinical significance.