综合护理对瓣膜置换患者围手术期血糖、体液免疫与细胞免疫的影响

Effect of comprehensive nursing on perioperative blood glucose,humoral immunity and cellular immunity of patients with valve replacement

目的探讨不同护理方法对瓣膜置换患者围手术期血糖、体液免疫水平与细胞免疫水平的影响。方法将117例瓣膜置换患者随机分为观察组和对照组,对照组51例,观察组66例。对照组采用常规护理,观察组采用综合护理。比较不同护理方法对患者血糖、体液免疫水平与细胞免疫水平的影响。结果两组术前、体外循环中、停机24 h的血糖变化比较,P均>0.05;两组停机时、停机5 h后血糖比较,P<0.05。两组术前IL-6水平变化比较,P>0.05;两组体外循环中、停机时、停机后5 h、术后24 h IL-6水平变化比较,P<0.05;两组术前TNF-α水平变化比较,P>0.05;两组体外循环中、停机时、停机后5 h、术后24 h TNF-α水平变化比较,P均<0.05;两组术前CD_(4)^(+)、CD_(8)^(+)、CD_(3)^(+)、CD_(4)^(+)/CD_(8)^(+)水平比较,P均>0.05;两组术后第1天、第7天、第14天CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)水平比较,P均<0.05。结论综合护理可有效改善瓣膜置换患者血糖水平及免疫水平。

Objective To explore different nursing methods on perioperative blood glucose,humoral immunity and cellular immunity of patients with valve replacement.Methods 117 cases of patients with valve replacement in our hospital were selected and randomly divided into the control group and the observation group.51 cases in the control group received routine nursing.66 cases in the observation group received comprehensive nursing.The blood glucose,humoral immunity and cellular immunity of the two groups were compared.Results The comparison of blood glucose between the two groups before operation,during extracorporeal circulation,24 h after machine stopped were with P>0.05;The comparison of that at the time of machine stopped and 5 h after machine stopped were with P<0.05.The comparison of IL-6 and TNF-αbetween the two groups before operation were with P>0.05;the comparison of those during extracorporeal circulation,5 h after machine stopped and 24 h after machine stopped were with P<0.05.The comparison of CD_(3)^(+),CD_(4)^(+),CD_(8)^(+)and CD_(4)^(+)/CD_(8)^(+)between the two groups before operation were with P>0.05;the comparison of those 1d,7d and 14d after operation were with P<0.05.Conclusion Different nursing methods have positive influence on perioperative blood glucose,humoral immunity and cellular immunity of patients with valve replacement.