术中复合保温管理对肝癌手术患者应激反应、凝血功能和低体温发生的影响

Effect of Intraoperative Compound Thermal Insulation Management on Stress Response,Coagulation Function and Hypothermia in Patients Undergoing Liver Cancer Surgery

目的:研究术中复合保温管理对肝癌手术患者应激反应、凝血功能和低体温发生的影响。方法:选取2021年2月—2022年12月于莆田市第一医院治疗的100例肝癌手术患者,根据随机数表法分为两组,各50例。观察组采用术中复合保温管理方式,对照组采用常规保温方式。比较两组的凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)和纤维蛋白原(FIB)水平,比较两组的醛固酮(ALD)、皮质醇(Cor)和促肾上腺皮质激素(ACTH)水平,比较两组的低体温发生率。结果:术前,两组TT、PT、APTT和FIB比较,差异无统计学意义(P>0.05);术后,观察组TT、PT、APTT均高于术前,对照组TT、PT、APTT和FIB均高于术前,但观察组TT、PT、APTT和FIB低于对照组,差异有统计学意义(P<0.05)。术前,两组ALD、Cor和ACTH比较,差异无统计学意义(P>0.05);术后,两组ALD、Cor均高于术前,但观察组ALD、Cor低于对照组,差异有统计学意义(P<0.05)。观察组低体温发生率显著低于对照组,差异有统计学意义(χ^(2)=5.005,P=0.025)。结论:术中复合保温管理能有效改善肝癌手术患者的应激反应、凝血功能,降低低体温发生率。

Objective:To explore the effect of intraoperative compound thermal insulation management on stress response,coagulation function,and hypothermia in patients undergoing liver cancer surgery.Method:A total of 100 patients with liver cancer who were treated in Putian First Hospital from February 2021 to December 2022 were selected,and they were divided into two groups according to the random number table,with 50 patients in each group.The observation group used intraoperative compound thermal insulation management,while the control group used conventional insulation.The levels of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)were compared between the two groups,the levels of aldosterone(ALD),cortisol(Cor)and adrenocorticotropic hormone(ACTH)were compared between the two groups,and the incidence of hypothermia was compared between the two groups.Result:Before surgery,there were no significant differences in TT,PT,APTT and FIB between the two groups(P>0.05).After surgery,TT,PT and APTT in the observation group were higher than those before surgery,while TT,PT,APTT and FIB in the control group were higher than those before surgery,but TT,PT,APTT and FIB in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Before surgery,there were no significant differences in ALD,Cor and ACTH between the two groups(P>0.05).After surgery,the ALD,Cor levels in both groups were higher than those before surgery,but the ALD,Cor levels in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).The incidence of hypothermia in the observation group was significantly lower than that in the control group,the difference was statistically significant(X^(2)=5.005,P=0.025).Conclusion:Intraoperative compound thermal insulation management can effectively improve the stress response,coagulation function,and reduce the incidence of hypothermia in patients undergoing liver cancer surgery.