循证护理干预在预防小儿腹腔镜手术围术期低体温中的应用

Application of Evidence-based Nursing Intervention in Preventing Hypothermia During Perioperative Period of Laparoscopic Surgery in Children

目的探讨循证护理干预在预防小儿腹腔镜手术围术期低体温中的临床效果。方法方便选择2019年1—12月该院行腹腔镜手术并预估手术时间>2 h的患儿共114例,根据手术方式进行匹配后随机分组,对照组给予常规护理,观察组应用最新循证护理干预预防围术期低体温。对比两组术中体温及术后并发症情况(术后呼吸抑制、切口感染、寒战及苏醒时间)。结果两组患儿术中30 min及术中1 h体温差异无统计学意义(t=0.000、0.696,P=1.000、0.488)。对照组术中2 h体温(35.17±0.27)℃,低于观察组(36.32±0.33)℃,差异有统计学意义(t=20.363,P<0.001)。术中低体温发生率24.6%高于观察组5.3%,差异有统计学意义(χ^(2)=8.365,P=0.001)。对照组术后寒战发生率为17.5%,高于观察组的3.5%,差异有统计学意义(χ^(2)=5.961,P=0.015)。观察组术后呼吸抑制、切口感染均为0.0%,对照组分别为3.5%、1.8%,两组差异无统计学意义(χ^(2)=2.036、1.009,P=0.154、0.315)。结论围术期循证护理干预能降低高危小儿腹腔镜手术中低体温的发生,降低术后低体温及寒战发生率,循证护理干预的培训及应用具有推广价值。

Objective To explore the clinical effect of evidence-based nursing intervention in preventing perioperative hypothermia during laparoscopic surgery in children.Methods A total of 114 pediatric patients who underwent laparoscopic surgery in the hospital from January to December 2019 and estimated the operation time>2 hours were randomly selected and randomly grouped according to the operation method.The control group was given routine care and the observation group adopted the latest evidence-based nursing intervention to prevent perioperative hypothermia.The intraoperative body temperature and postoperative complications(postoperative respiratory depression,incision infection,chills and recovery time)were compared between the two groups.Results There was no significant difference in body temperature between the two groups of children at 30 min and 1 h during the operation(t=0.000,0.696,P=1.000,0.488).The intraoperative body temperature of the control group(35.17±0.27)℃was lower than the observation group(36.32±0.33)℃,the difference was statistically significant(t=20.363,P<0.001),the incidence of intraoperative hypothermia was 24.6%higher than the observation group 5.0%,the difference was statistically significant(χ^(2)=8.365,P=0.001).The incidence of postoperative shivering in the control group was 17.5%,which was higher than 3.5%in the observation group,and the difference was statistically significant(χ^(2)=5.961,P=0.015).Postoperative respiratory depression and wound infection were 0.0%in the observation group,3.5%and 1.8%in the control group.There was no significant difference between the two groups(χ^(2)=2.036,1.009,P=0.154,0.315).Conclusion Perioperative evidence-based nursing intervention can reduce the incidence of hypothermia during laparoscopic surgery in high-risk children,and reduce the incidence of postoperative hypothermia and chills.The training and application of evidence-based nursing intervention has promotion value.