复合保温护理在经皮肾镜碎石取石术中的应用

Application of Comprehensive Thermal Insulation Nursing Cares in Percutaneous Nephrolithotomy under General Anesthesia

目的探讨复合保温护理措施对全麻下经皮肾镜碎石取石术患者术后应激、术后苏醒及手术满意度的影响。方法选取本院2019年1月—2020年3月全麻下行经皮肾镜碎石取石术的患者92例,根据护理方式随机分为两组。对照组46例,给予常规护理措施,实验组46例,给予复合保温护理措施。比较两组手术前后生命体征的变化情况(体温、收缩压、舒张压、心率)、术后苏醒情况(拔管时间、完全清醒时间、麻醉后监测治疗室滞留时间、寒战、躁动发生率)、败血症发生率、手术满意度(热舒适视觉模拟评分、住院满意度视觉模拟评分)及住院时间。结果实验组术前术后体温和心率与对照组相比,差异有统计学意义(P<0.05);实验组术后收缩压及舒张压均比对照组低,差异有统计学意义(P<0.05)。实验组在出血量、输液量及手术时间方面与对照组之间的差异均无统计学意义(P>0.05)。实验组的拔管时间、完全清醒时间、麻醉后监测治疗室滞留时间较对照组短,实验组寒战及躁动发生率较对照组低,实验组手术开始前及离开手术室时热舒适视觉模拟评分、住院满意度视觉模拟评分较对照组高,差异均有统计学意义(P<0.05)。结论全麻下行经皮肾镜碎石取石术的患者接受复合保温护理措施可有效地稳定患者生命体征、降低寒战及躁动的发生率,减轻术后应激反应,加快术后苏醒,提高患者手术满意度,值得进一步推广。

Objective To explore the effect of comprehensive thermal insulation nursing cares on postoperative stress,awakening and satisfaction in patients undergoing percutaneous nephrolithotomy under general anesthesia.Methods 92 patients who underwent percutaneous nephrolithotomy in our hospital from January 2019 to March 2020 were selected and randomly divided into two groups according to the pattern of nursing care.46 patients in the control group were given routine nursing cares,46 patients in the experimental group were given comprehensive thermal insulation nursing cares.The changes of vital signs(body temperature,systolic blood pressure,diastolio blood pressure and heart rate),postoperative awakening(extubation time,fully awake time,postanesthesia care unit retention time,shivering and restlessness),the incidence of spesis,operation satisfaction(thermal comfort visual points,hospital satisfaction visual analogue scale)and the length of hospital stay were compared between the two groups.Results There was significant difference in body temperature and heart rate between the two groups before and after operation(P<0.05),and the postoperative systolic and diastolic blood pressure in the experimental group were significantly lower thar those in the control group(P<0.05),and the difference was statistically significant.There was no significant difference in blood loss,infusion volume and operation time between the experimental group and the control group(P>0.05).The extubation time,fully awake time and postanesthesia care unit retention time in the experimental group were shorter than those in the control group,and the incidence of chills and restlessness in the experimental group was lower than that in the control group(P<0.05).The visual analog scale of thermal comfort before operation and after leaving the operating room,and inpatient satisfaction were higher in the experimental group than in the control group(P<0.05).The differences between the two groups were statistically significant.Conclusion Comprehensive thermal insulation nursing cares for patients undergoing percutaneous nephrolithotomy can effectively maintain the stability of vital signs,reduce the incidence of chills and restlessness,reduce postoperative stress response,accelerate postoperative recovery,and improve patients’surgical satisfaction,which is worth popularizing.