Pender健康促进模式联合手术室综合性保温护理在老年脊柱手术患者中的应用效果

Application effect of Pender's health promotion model combined with operating room comprehensive thermal insulation nursing in elderly patients undergoing spinal surgery

目的探讨Pender健康促进模式联合手术室综合性保温护理在老年脊柱手术患者中的应用效果。方法选取2019年11月至2020年5月广州市荔湾区骨伤科医院收治的83例需行脊柱手术的老年患者作为研究对象,采用随机数字表法分为对照组(42例)和观察组(41例),对照组采用常规护理与手术常规保温措施进行干预,观察组采用Pender健康促进模式联合手术室综合性保温护理进行干预。比较两组患者围手术期(术前30 min,术中30、60 min以及术后30 min)鼻咽温度、术后寒战发生率、干预前后认知水平以及负面情绪变化。结果两组患者围手术期鼻咽温度时间、组间及交互效应比较,差异有统计学意义(F=22.157、25.803、39.175,P<0.05);其中对照组术中30、60 min,术后30 min时的鼻咽温度均低于术前30 min,差异有统计学意义(P<0.05),而观察组术中30、60 min,术后30 min时的鼻咽温度与术前30 min时比较,差异均无统计学意义(P>0.05),且观察组术中30、60 min,术后30 min鼻咽温度均高于对照组,差异有统计学意义(P<0.05);术后对照组发生寒战9例,观察组2例,观察组术后寒战发生率低于对照组,差异有统计学意义(P<0.05);观察组干预后简易智力调查量表(MMSE)评分高于对照组,焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P<0.05)。结论Pender健康促进模式联合手术室综合性保温护理与常规护理与手术室常规保温措施相比,前者对老年脊柱手术患者围手术期保温效果更好,可显著减少术后寒战以及认知功能障碍(POCD)发生情况、缓解负面情绪,具有较好的临床应用价值。

Objective To discuss the application effect of Pender's health promotion model combined with operating room comprehensive thermal insulation nursing in elderly patients undergoing spinal surgery.Methods A total of 83 elderly patients who underwent spinal surgery in Guangzhou Liwan District Orthopedic Hospital from November 2019 to May 2020 were selected as research projects.According to the random number table method,the patients were divided into control group(42 cases)and observation group(41 cases).The control group was intervened with routine nursing combined with operation routine thermal insulation measures,while the observation group was intervened with Pender health promotion model combined with comprehensive thermal insulation nursing in operating room.The nasopharyngeal temperature,incidence of postoperative shivering,cognitive level and negative emotion changes before and after intervention were compared between the two groups during perioperative period(30 min before operation,30 and 60 min during operation,30 min after operation).Results There were statistically significant differences in nasopharyngeal temperature time,inter-group and interaction effects between the two groups(F=22.157,25.803,39.175,P<0.05).The nasopharyngeal temperature at 30 and 60 min during opertation,and 30 min after operation in the control group were lower than that at 30 min before operation,with statistically significant differences(P<0.05).While,there were no significant differences in the temperature of nasopharynx in the observation group at 30 and 60 min and 30 min after operation compared with that at 30 min before operation(P>0.05).And the nasopharyngeal temperature at 30 and 60 min and 30 min after operation in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).There were 9 cases of postoperative shivering in the control group and 2 cases in the observation group,and the incidence of postoperative shivering in the observation group was lower than that in the control group,with a was statistically significant difference(P<0.05).After intervention,the score of mini mental sate examination(MMSE)in the observation group was higher than that in the control group,and the score of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)in the observation group were lower than those in the in the control group,with statistically significant differences(P<0.05).Conclusion Pender's health promotion model combined with operating room comprehensive thermal insulation nursing is conducive to body temperature of patients during spinal surgery,which can significantly reduce the incidence rates of postoperative chills and postoperative cognitive dysfunction,and relieve the patients'negative emotions.