精细化护理在综合预防术中低体温中的应用与探讨

Application and Discussion of Fine Nursing in Comprehensive Prevention of Hypothermia

目的在术中常规保温措施的基础上增加加热毯边缘包裹气腹管路进行二次加热的护理措施来观察其对腹腔镜疝气手术低体温和术后并发症的发生情况及对机体的影响。方法将辽宁省某三甲综合医院2017年和2018年收治的实施腹腔镜股沟疝气术的患者50例纳入本次研究中,随机分成精细化护理组和一般护理组,一般护理组行常规护理,精细化护理组在常规护理基础上增加护理措施,分析两组患者的术中低体温发生情况,包括手术过程中不同时间点的体温情况、SSI例数。结果两组术前体温、手术时长、术中擦镜次数、SSI例数差异无统计学意义(P>0.05)。手术结束时体温与术前体温相比,精细化护理组组体温升高(0.51±0.22)℃,一般护理组体温升高(0.20±0.25)℃,一般护理组体温变化的幅度低于精细化护理组,差异具有统计学意义(t=4.578,P<0.01),比对两组数值,术中1 h体温,及术中1 h腹腔内温,结束时体温和离室体温,寒战,PICU时长,差异均具有统计学意义(P<0.05)。结论腹腔镜疝气手术时在常规体温护理的基础上增加护理措施,在未给患者增加医疗成本的同时可预防术中低体温的发生,提升围手术期优质护理服务质量。

Objective On the basis of the conventional heat preservation measures during the operation,the nursing measures of heating the pneumoperitoneum tube wrapped around the edge of the heating blanket were added to observe the occurrence of hypothermia and postoperative complications of laparoscopic hernia surgery and its impact on the body.Methods Fifty patients undergoing laparoscopic inguinal hernia surgery admitted in 2017 and 2018 in a tertiary general hospital in Liaoning province were included in this study,and they were randomly divided into a refined care group and a general care group.The general care group received routine care.The refined care group added nursing measures on the basis of conventional nursing,and analyzed the occurrence of intraoperative hypothermia of the two groups of patients,including the body temperature at different time points during the operation and the number of SSI cases.Results There was no statistically significant difference between the two groups in preoperative body temperature,operation duration,intraoperative wiping times,and number of SSI cases(P>0.05).Compared with the preoperative body temperature at the end of the operation,the body temperature of the refined care group increased by(0.51±0.22)℃,and the body temperature of the general care group increased by(0.20±0.25)℃.The temperature change of the general care group was lower than that of the refined care group.The difference is statistically significant(t=4.578,P<0.01).Compare the two groups'values,intraoperative 1 h body temperature,and 1 h intra-abdominal temperature during operation,body temperature at the end and out-of-room body temperature,chills,PICU duration,The differences were statistically significant(P<0.05).Conclusion In laparoscopic hernia surgery,nursing measures are added on the basis of routine body temperature nursing,which prevents the occurrence of intraoperative hypothermia without increasing medical costs for the patient,and improves the quality of perioperative care services.