综合保温对肝胆胰开腹手术患者术中血流动力学稳定的影响

目的 探讨综合保温对肝胆胰开腹手术患者术中血流动力学稳定的影响.方法 选取2016年2月至2018年3月在本院行肝胆胰开腹手术患者88例,依据非随机数字表法即住院号的单双分为对照组(n=44,予以常规护理干预)和观察组(n=44,予以规范化护理干预).分析两组患者术中核心体温及血流动力学变化,比较两组患者不良事件发生率及护理满意度.结果 手术开始后两组患者鼓膜温度均呈现明显下降趋势,且术中各时间点鼓膜温度均低于手术开始时,差异有统计学意义(P<0.05);组间比较,观察组患者鼓膜温度下降幅度优于对照组,差异有统计学意义(P<0.05);观察组术中低体温发生率4.56%(2/44)少于对照组术中低体温发生率11.36%(5/44).两组患者术中、术毕收缩压(SBP)、舒张压(DBP)、心率(HR)和平均动脉压(MAP)水平均较入室时高,且术毕水平低于术中水平,差异有统计学意义(P<0.05);组间比较,观察组患者SBP、DBP、HR及MAP水平优于对照组,差异有统计学意义(P<0.05).观察组患者总满意度高于对照组,差异有统计学意义(P<0.05).结论 对肝胆胰开腹手术患者实施综合保温护理干预,不仅能有效控制患者术中体温波动,减少低体温发生率,有利于维持血流动力学稳定,还能提高患者满意度.

Objective To investigate the effect of standardized nursing intervention on the stability of intraoperative hemodynamics in patients with hepatobiliary and pancreatic open surgery.Methods 88 patients with hepatobiliary and pancreatic open surgery in the hospital from Febmary 2016 to March 2018 were selected,and they were divided into two groups by odd and even admission numbers,with 44 cases in each group.Control group was given routine nursing intervention,while observation group was given standardized nursing intervention.The changes of intraoperative core body temperature and hemodynamics of two groups were analyzed.The incidence of adverse events and nursing satisfaction were compared between the two groups.Results There was no statistical difference in the tympanic temperature between the two groups at the beginning of surgery(P>0.05).After the beginning of surgery,the tympanic temperature of two groups showed the decreased trend,and the tympanic temperature during the surgery was lower than that at the beginning of surgery(P<0.05).The decreased range of tympanic temperature in observation group was smaller,and it was better than control group(P<0.05).There was no statistical difference in the levels of SBP,DBP,HR,MAP between the two groups at TO(P>0.05).The levels of SBP,DBP,HR,MAP in two groups at T1 and T2 were higher than those at TO,and the levels at T2 were lower than those at T1(P<0.05).The levels of SBP,DBP,HR,MAP in observation group were better than those in control group(P<0.05).The total incidence of adverse events in observation group was lower than that in control group(P<0.05).The total satisfaction of observation group was higher than that of control group(P<0.05).Conclusion Standardized nursing intervention for patients with hepatobiliary and pancreatic open surgery can effectively control intraoperative temperature fluctuation,maintain the stability of hemodynamics,reduce adverse events and increase satisfaction.