术中保温护理联合正念冥想训练对腹腔镜妇科手术患者低体温、应激反应和凝血功能的影响

Influence of intraoperative heat preservation nursing combined with mindfulness meditation training on hypothermia,stress response and coagulation function in patients undergoing laparoscopic gynecological surgery

目的探讨正念冥想训练联合术中保温护理对腹腔镜妇科手术患者应激反应、低体温和凝血功能的影响。方法选择2018年6月—2020年6月本院收治的92例腹腔镜妇科手术患者作为研究对象,采用随机数表法分为观察组与对照组两组,每组各46例。对照组给予腹腔镜妇科手术围术期常规护理干预,观察组在对照组的基础上给予正念冥想训练联合术中保温护理干预。比较两组患者围术期体温变化、术后苏醒时间、尿量、凝血功能、应激反应指标、低体温发生率。结果观察组患者术中及术后体温均高于对照组,差异有统计学意义(P<0.05);观察组患者术后苏醒时间短于对照组,差异有统计学意义(P<0.05);观察组患者术后尿量少于对照组,差异有统计学意义(P<0.05);干预后,观察组患者凝血酶原时间、活化部分凝血活酶时间、凝血酶时间、指标明显低于对照组,纤维蛋白原指标高于对照组,差异有统计学意义(P<0.05);干预后,观察组患者血清皮质醇、去甲肾上腺素水平低于对照组,差异有统计学意义(P<0.05);观察组患者低体温发生率(8.70%)低于对照组(26.09%),差异有统计学意义(P<0.05)。结论术中保温护理联合正念冥想训练对腹腔镜妇科手术患者护理干预效果良好,能够降低患者术后低体温发生率,缩短患者术后的苏醒时间,减少患者术后尿量,改善患者术后的凝血功能,减轻机体的应激反应。

Objective To investigate the influence of mindfulness meditation training combined with intraoperative heat preservation nursing on stress response,hypothermia and coagulation function in patients undergoing laparoscopic gynecological surgery.Methods 92 cases of patients undergoing laparoscopic gynecological surgery in our hospital from June 2018 to June 2020 were selected as the research objects,and they were randomly divided into observation group and control group,46 cases in each group.The control group was given routine nursing intervention in perioperative period of laparoscopic gynecological operation,and the observation group was given intraoperative heat preservation nursing combined with mindfulness meditation training on the basis of the control group.The perioperative body temperature changes,postoperative recovery time,urine volume,coagulation function,stress response indexes,incidence rate of hypothermia were statistically compared between the two groups.Results The intraoperative and postoperative body temperature of the observation group was higher than that of the control group(P<0.05),and the postoperative recovery time was shorter than that of the control group(P<0.05),and the urine volume was less than that of the control group(P<0.05).After intervention,coagulation function indexes including prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT)of the observation group were lower than those of the control group,while the fibrinogen(FIB)was higher than that of the control group(P<0.05).After intervention,the levels of serum cortisol(COR)and norepinephrine(NE)of the observation group were lower than those of the control group(P<0.05).The incidence rate of hypothermia of the observation group was 8.70%(4/46),and that in the control group was 26.09%(12/46).The incidence rate of hypothermia of the observation group was lower than that of the control group(P<0.05).Conclusions Intraoperative heat preservation nursing combined with mindfulness meditation training has a good effect on nursing intervention of patients undergoing laparoscopic gynecological surgery,which could reduce the incidence rate of postoperative hypothermia,shorten postoperative recovery time,reduce postoperative urine volume,improve postoperative coagulation function and reduce stress response of the body.