术中实施保温护理干预对肝癌切除术患者凝血功能及低体温发生率的影响

Effect of intraoperative heat preservation nursing intervention on coagulation function and incidence of hypothermia in patients undergoing hepatectomy

目的探讨术中实施保温护理干预对肝癌切除术患者凝血功能及低体温发生率的影响。方法选取2015年6月至2017年6月在我院行肝癌切除术的患者60例,以随机数字表法将其分为研究组和对照组,各30例。对照组患者采取常规护理,研究组患者实施保温护理干预。比较两组患者手术中的输液量、输血量、手术时间,手术前、后的凝血功能[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)及纤维蛋白原(FIB)]。比较两组患者低体温发生率及护理满意度。结果两组患者手术中的输液量、输血量及手术时间比较,差异无统计学意义(P>0.05)。手术前,两组患者的TT、PT、APTT及FIB水平比较,差异不显著(P>0.05);手术后,两组患者的TT、PT及APTT均延长,FIB水平均升高,且研究组明显优于对照组,差异具有统计学意义(P<0.05)。研究组患者手术中低体温发生率为13.33%,明显低于对照组的43.33%(P<0.05)。研究组患者的护理满意度为93.33%,明显高于对照组的66.67%(P<0.05)。结论术中实施保温护理干预能够明显降低肝癌切术患者低体温发生率,有利于维持患者正常的凝血功能,同时还可提高护理满意度,值得临床推广应用。

Objective To explore the effect of intraoperative heat preservation nursing intervention on coagulation function and incidence of hypothermia in patients undergoing hepatectomy. Methods Sixty patients who underwent hepatectomy in our hospital from June 2015 to June 2017 were selected and split into study group and control group by random number table method, with 30 cases in each group. The patients in the control group were given routine nursing,while the patients in the study group were given intraoperative heat preservation nursing intervention. The intraoperative infusion volume, blood transfusion volume, operation time, coagulation function [thrombin time(TT), prothrombin time(PT),activated partial thrombin time(APTT) and fibrinogen(FIB)] before and after operation were compared between the two groups. The incidence of hypothermia and nursing satisfaction were compared between the two groups. Results There were no significant differences in the intraoperative infusion volume, blood transfusion volume and operation time between the two groups(P>0.05). Before operation, there were no significant differences in TT, PT, APTT and FIB level between the two groups(P>0.05). After operation, the TT, PT and APTT prolonged, and the FIB levels increased in both groups and those in the study group were significantly better than the control group, with statistically significant differences(P<0.05). The incidence of hypothermia was 13.33% in the study group, which was significantly lower than 43.33% in the control group(P<0.05). The nursing satisfaction of the study group was 93.33%, which was significantly higher than 66.67% in the control group(P <0.05). Conclusion Intraoperative heat preservation nursing intervention applied in patients undergoing hepatectomy can significantly reduce the incidence of hypothermia, help to maintain the normal coagulation function of patients and improve nursing satisfaction, which is worthy of clinical promotion and application.