术中复合保温护理干预对高龄普外手术患者术中体温波动及术后寒颤及并发症的影响

Efficacy of nursing intervention of compound insulation on temperature fluctuation during surgery, shiver and complications after surgery in elderly patients with general surgery

目的:研究术中复合保温护理干预对高龄普外手术患者术中体温波动及术后并发症的影响。方法:纳入我院普外科180例行腹部手术治疗的高龄患者(≥60岁),依据护理干预方式不同,随机分为对照组(n=90)和观察组(n=90),对照组给予常规保温护理干预,观察组在常规护理基础上给予术中复合保温护理干预,比较两组围手术期生命体征、术中体温波动变化、术后指征和并发症情况。结果:观察组术中、术毕1h的鼻咽温显著高于对照组(P<0.05),心率、血压显著低于对照组(P<0.05),两组氧饱和度差异不显著(P>0.05);观察组患者麻醉开始、手术开始、手术0.5h、手术1h和麻醉结束体温显著高于对照组,差异具有统计学意义(P<0.05);观察组患者苏醒时间、手术至拔管时间、尿量、引流量均显著短于或少于对照组,差异具有统计学意义(P<0.05),两组手术时间无显著性差异(P>0.05);观察组寒颤率、躁动率、低体温率显著低于对照组,差异具有统计学意义(P<0.05)。结论:对行腹部手术治疗的高龄患者,术中采取复合保护护理干预可显著降低其围手术期体征波动幅度,缩短患者苏醒、恢复时间,降低术后寒颤、躁动、体低温等并发症,临床意义显著,值得推广。

Objective:To observe efficacy of nursing intervention of compound insulation on temperature fluctuation during surgery,shiver and complications after surgery in elderly patients with general surgery.Methods:180 cases were divided into two groups,90 cases in each group.The control group was given conventional thermal nursing.The observation group took nursing of compound insulation.Results:In the observation group,the nasopharygeal temperature was significantly higher than the control group(P<0.05)during the operation and 1h after operation,and the heart rate and blood pressure were significantly lower(P<0.05).The difference in oxygen saturation between the two groups was not significant(P>0.05).In the observation group,temperature at anesthesia began,the beginning of surgery,0.5h after surgery,1h after surgery and end of anesthesia was significantly higher than the control group,the difference was statistically significant(P<0.05).Awake time,surgery to extubation time,the urine volume and drainage volume were all significantly shorter or less than the control group(P<0.05).There was no significant difference in the operation time between two groups(P>0.05).The chill rate,the turbulent rate,and the low level were lower in the observation group(P<0.05).Conclusion:For elderly patients undergoing abdominal surgery,nursing during the operation can significantly reduce the fluctuating amplitude of perioperative signs,shorten time of recovery,improve postoperative chills,restlessness,hypothermia and other complications,is worthy of promotion.