NBASS-APS模式对胃癌手术患者麻醉恢复期低温及苏醒延迟的影响

Effects of NBASS-APS mode on hypothermia and recovery delay during anesthesia recovery in patients with gastric cancer

目的:探讨护士为基础、以麻醉医师和专科为指导的急性疼痛服务模式(nurse-based,anesthesiologist and specialist-supervised APS,NBASS-APS)对胃癌手术患者麻醉恢复期低温及苏醒延迟的影响。方法:选取2016年6月至2018年3月于本院行择期胃癌根治术患者89例,根据护理方法的不同分为观察组49例与对照组40例,对照组给予常规护理,观察组在对照组护理的基础上给予NBASS-APS模式护理,记录两组患者麻醉恢复期低温及苏醒延迟情况。结果:两组患者的术中输液量、手术时间及术中出血量等对比差异无统计学意义(P>0.05)。观察组T2、T3、T4时间点的鼻咽部温度都高于对照组,对比差异有统计学意义(P<0.05)。观察组的术后苏醒时间、拔管时间及住院时间等均少于对照组,对比差异有统计学意义(P<0.05)。术后观察组苏醒延迟、寒战、躁动等并发症发生率为2.0%、4.1%、4.1%,低于对照组的12.5%、17.5%和20.0%,对比差异有统计学意义(P<0.05)。结论:NBASS-APS模式在胃癌手术患者中的应用能维持麻醉恢复期体温正常,缩短苏醒延迟时间,降低苏醒延迟的发生率。

Objective:To investigate the effects of NBASS-APS mode on hypothermia and recovery delay during anesthesia recovery in patients with gastric cancer.Methods:From June 2016 to March 2018,89 patients undergoing elective radical gastrectomy in our hospital were enrolled and were divided into the 49 patients in the observation group and 40 patients in the control group accorded to the different nursing methods.The control group was received routine nursing care,and the observation group was given the NBASS-APS mode nursing on the basis of the control group,and the low temperature and recovery delay of the two groups during the recovery period of anesthesia were recorded.Results:There were no significant differences in the operation time,intraoperative fluid volume,intraoperative blood loss,and anesthesia time compared between the two groups(P>0.05).The nasopharynx temperature at the time points of T2,T3 and T4 in the observation group were significantly higher than that in the control group and differences were statistically significant(P<0.05).The postoperative extubation time,recovery time,first time to get out of bed,staying time in anesthesia recovery room,and hospitalization time were significantly lower in the observation group than in the control group,and differences were statistically significant(P<0.05).The incidence of postoperative recovery,chills,and agitation in the observation group were 2.0%,4.1%,and 4.1%,which were significantly lower than 12.5%,17.5%,and 20.0%of the control group,and differences were statistically significant(P<0.05).Conclusion:The application of NBASS-APS mode in patients with gastric cancer surgery can maintain normal body temperature during anesthesia recovery,shorten the delay time of recovery and reduce the incidence of recovery delay.