充气式加温仪在腹腔镜子宫肌瘤剔除术中保温护理的应用及对患者循环代谢和术后复苏的影响研究

Application of Inflatable Heating Instrument in Nursing Care of Laparoscopic Hysteromyomectomy and its Effect on Circulatory Metabolism and Postoperative Resuscitation

目的:分析充气式加温仪在腹腔镜子宫肌瘤剔除术中保温护理的应用及对患者循环代谢和术后复苏的影响。方法:选择2019年1月―2020年6月河南科技大学第一附属医院收治的98例腹腔镜子宫肌瘤剔除术患者作为研究对象,根据术中是否使用充气式加温仪,将患者分成对照组(否)47例和观察组(是)51例。对照组接受常规保温护理,观察组患者接受充气式加温仪保温。比较两组患者循环代谢、手术时间、苏醒时间、补液量、应激反应发生情况和不良反应发生情况。结果:术后30 min两组患者腋下温度较术前下降,其中观察组腋下温度高于对照组,差异有统计学意义(t=39.254,P<0.05)。术后30 min两组患者呼气末二氧化碳分压(PETco2)值较术前增高,且观察组PETco2低于对照组,差异有统计学意义(t=2.950,P<0.05)。观察组手术时间、苏醒时间及补液量少于对照组,差异有统计学意义(t=4.169、7.196、52.570,P<0.05)。术毕放气后,两组患者肾上腺素、去甲肾上腺素水平较气腹前10 min升高,但观察组肾上腺素、去甲肾上腺素水平低于对照组,差异有统计学意义(t=8.957、5.475,P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(χ^(2)=7.210,P<0.05)。结果:充气式加温仪应用于护理腹腔镜子宫肌瘤剔除术患者中,能够明显保护术中机体循环代谢,减少应激反应发生率,促使患者术后尽快复苏,建议临床推广使用。

Objective:To analyze the application of inflatable warming apparatus in nursing care of laparoscopic hysteromyomectomy and its effect on circulatory metabolism and postoperative resuscitation.Methods:A total of 98 patients with laparoscopic myomectomy who were admitted to the hospital from January 2019 to June 2020 were selected as the research subjects.The patients were divided into the control group(no)with 47 cases and the observation group(yes)with 51 cases according to whether the gas-filled warmer was used during the operation.The control group received routine heat preservation nursing,and the observation group received the inflatable warmer for heat preservation.The circulatory metabolism,operation time,recovery time,fluid volume,stress response and adverse reactions were compared between the two groups.Results:At 30 min after operation,the axillary temperature of the two groups was lower than that before operation,and the axillary temperature of the observation group was higher than that of the control group,and the difference was statistically significant(t=39.254,P<0.05).30 min after operation,the endtidal carbon dioxide partial pressure(PETco2)value of the two groups was higher than that before operation,and the PETco2 value of the observation group was lower than that of the control group,the difference was statistically significant(t=2.950,P<0.05).The operation time,recovery time and fluid volume in the observation group were less than those in the control group,and the differences were statistically significant(t=4.169,7.196,52.570,P<0.05).After deflation after surgery,the levels of epinephrine and norepinephrine in the two groups were higher than those 10 min before pneumoperitoneum,but the levels of epinephrine and norepinephrine in the observation group were lower than those in the control group,and the difference was statistically significant(t=8.957,5.475,P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=7.210,P<0.05).Conclusion:The inflatable warmer is used in the nursing of patients undergoing laparoscopic myomectomy,which can significantly protect the body’s circulation and metabolism during the operation,reduce the occurrence of stress reactions,and promote the recovery of patients as soon as possible after surgery.It is recommended for clinical promotion.