恒温保温毯下肢保温对老年胃癌全麻手术患者的影响

The Influence of Thermostatic Thermal Insulation Blanket on Lower Extremity Thermal Insulation in Senile Patients undergoing General Anesthesia for Gastric Cancer

目的探讨36.5℃恒温保温毯下肢保温对老年胃癌全麻手术患者复苏质量、应激反应及血栓形成的影响。方法选择新泰市人民医院2020年9月—2022年9月收治的117例老年胃癌全麻手术患者作为研究对象,采用随机数字表法分为对照组58例和观察组59例。对照组给予体腔内直接保温;观察组在其基础上增加36.5℃恒温保温毯进行下肢保温。比较两组患者的应激反应、复苏质量和深静脉血栓(deepveinthrombosis,DVT)形成情况。结果干预后观察组拔管时间、拔管后语言应答时间、苏醒时间、完全清醒时间和离室时间均短于对照组,而苏醒评分高于对照组,差异有统计学意义(P<0.05)。观察组术后血清肾上腺激素、去甲肾上腺素、C反应蛋白水平均低于对照组,差异有统计学意义(P<0.05)。观察组术后血清D-二聚体水平低于对照组,差异有统计学意义(P<0.05);观察组DVT发生率1.69%,低于对照组的13.79%,差异有统计学意义(P<0.05)。结论36.5℃恒温保温毯下肢保温能够缩短胃癌全麻手术术后苏醒时间,提高复苏质量,降低血清D-二聚体浓度和DVT发生率。

Objective To study the effects of 36.5℃thermostatic thermal insulation blanket on the quality of resuscitation,stress response and thrombosis in elderly patients undergoing general anesthesia for gastric cancer.Methods 117 elderly patients with gastric cancer undergoing general anesthesia surgery admitted to Xintai People’s Hospital from September 2020 to September 2022 were selected as the study subjects.They were randomly divided into a control group of 58 cases and an observation group of 59 cases by a random number table method.The control group received direct insulation in the body cavity.The observation group added a 36.5℃constant temperature insulation blanket based on it for lower limb temperature care.The stress response,resuscitation quality,and deep vein thrombosis(DVT)formation between two groups of patients were compared.Results After intervention,extubation time,language response time after extubation,recovery time,full wakefulness time and time out of room time in observation group were shorter than those in control group,and recovery score was higher than that in control group,the differences were statistically significant(P<0.05).The levels of adrenal hormone,norepinephrine and C-reactive protein in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Postoperative serum D-dimer level in the observation group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).The incidence of DVT in the observation group was 1.69%which was lower than that in the control group 13.79%,the difference was statistically significant(P<0.05).Conclusion 36.5℃thermostatic insulation blanket can shorten postoperative recovery time,improve resuscitation quality,reduce serum D-dimer concentration and incidence of DVT in patients with gastric cancer undergoing general anesthesia.