下肢骨折切开复位术中手术室主动保温干预效果研究

Study on the effect of active thermal insulation intervention in operating room during open reduction of lower extremity fractures

目的:研究下肢骨折切开复位术中手术室主动保温干预的应用效果。方法:选取2019年9月-2021年9月行切开复位术治疗的82例下肢骨折患者,按随机数字表法分组,对照组(41例)行常规保温干预,试验组(41例)行手术室主动保温干预,对比两组不同时刻耳温、血栓弹力图指标,并比较两组凝血功能、舒适度及围术期指标。结果:试验组术后生理、心理及环境舒适度评分均高于对照组(P<0.05);试验组T3、T4时刻耳温均高于对照组(P<0.05);与对照组比较,试验组T3、T4时刻R值、K值更短,T4时MA值更长(P<0.05);试验组术后PT、TT、APTT水平均高于对照组,FIB水平低于对照组(P<0.05);与对照组比较,试验组术中出血量、24h引流量均更低(P<0.05)。结论:下肢骨折切开复位术中应用手术室主动保温干预,可减少出血量及引流量,促进舒适度提高,有利于维持凝血功能稳定。

Objective:To study the application effect of active thermal insulation intervention in operating room during open reduction of lower extremity fractures.Methods:A total of 82 patients with lower extremity fractures who were treated with open reduction from September 2019 to September 2021 were selected and grouped according to the random number table method.The control group(41 cases)received routine heat preservation intervention,and the experimental group(41 cases)received surgery.Room active insulation intervention was performed,ear temperature and thromboelastography indexes at different times were compared between the two groups,and coagulation function,comfort and perioperative indexes were compared between the two groups.Results:The postoperative physiological,psychological and environmental comfort scores in the experimental group were higher than those in the control group(P<0.05);the ear temperature at T3 and T4 in the experimental group were higher than those in the control group(P<0.05).The R value and K value were shorter at T3 and T4,and the MA value was longer at T4(P<0.05).The postoperative levels of PT,TT and APTT in the experimental group were higher than those in the control group,and the level of FIB was lower than that in the control group(P<0.05).compared with the control group,the intraoperative blood loss and 24-h drainage volume of the experimental group were lower(P<0.05).Conclusion:The application of active thermal insulation intervention in the operating room during open reduction of lower extremity fractures can reduce the amount of blood loss and drainage,promote the improvement of comfort,and help maintain the stability of coagulation function.