保温护理在麻醉苏醒期老年骨折手术患者中的应用效果

Application effects of heat preservation nursing in elderly patients with fracture surgery during anesthesia recovery period

目的:观察保温护理在麻醉苏醒期老年骨折手术患者中的应用效果。方法:选取2020年3月至2022年3月该院收治的82例老年骨折患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各41例。对照组实施常规护理,观察组在对照组基础上实施保温护理。比较两组麻醉苏醒时间(睁眼时间、定向力恢复时间、自主呼吸恢复时间)、不同时间[麻醉前10 min(T_(0))、麻醉后10 min(T_(1))、手术30 min(T_(2))、术毕即刻(T_(3))]血流动力学指标[心率、平均动脉压(MAP)]水平、护理前后氧化应激指标[去甲肾上腺素(NE)、肾上腺素(AD)、C反应蛋白(CRP)]水平、认知功能[简易智能精神状态检查量表(MMSE)]评分及并发症发生率。结果:观察组睁眼时间、定向力恢复时间及自主呼吸恢复时间均短于对照组,差异有统计学意义(P<0.05);T_(1)时,两组MAP、心率水平均高于T_(0)时,但观察组低于对照组,差异有统计学意义(P<0.05);T_(2)~T_(3)时,两组MAP、心率水平与T_(0)时比较,差异均无统计学意义(P>0.05);护理后,两组NE、AD及CRP水平均高于护理前,但观察组低于对照组,差异有统计学意义(P<0.05);观察组定向力、记忆力、注意力和计算力、回忆能力及语言能力等各项MMSE评分均高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为9.76%(4/41),低于对照组的26.83%(11/41),差异有统计学意义(P<0.05)。结论:保温护理应用于麻醉苏醒期老年骨折手术患者,可提高麻醉苏醒质量,稳定血流动力学指标水平,减轻机体氧化应激反应,促进认知功能恢复,降低并发症发生率,效果优于常规护理。

Objective:To observe application effects of heat preservation nursing in elderly patients with fracture surgery during anesthesia recovery period.Methods:A prospective study was conducted on 82 elderly patients with fractures admitted to the hospital from March 2020 to March 2022.They were divided into control group and observation group according to the random number table method,41 cases in each.The control group was given routine nursing,while the observation group was given the heat preservation nursing on the basis of that of the control group.The anesthesia recovery time(eye opening time,orientation recovery time,spontaneous breathing recovery time),the hemodynamic index levels [heart rate,mean arterial pressure(MAP)] level at different time [10 min before anesthesia(T_(0)),10 min after anesthesia(T_(1)),30 min after operation(T_(2)),immediately after operation(T_(3))],the oxidative stress index [norepinephrine(NE),epinephrine(AD),C-reactive protein(CRP)] levels before and after the nursing,the cognitive function [mini mental state examination(MMSE)] score,and the incidence of complications were compared between the two groups.Results:The eye opening time,the orientation recovery time and the spontaneous breathing recovery time in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).At T_(1),the MAP and heart rate levels of the two groups were higher than those at T_(0),but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).At T_(2)-T_(3),there were no significant differences in MAP and heart rate between the two groups compared with T_(0)(P>0.05).After the nursing,the levels of NE,AD and CRP in the two groups were higher than those before the nursing,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The MMSE scores of orientation,memory,attention and calculation,recall ability and language ability in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 9.76%(4/41),which was lower than 26.83%(11/41) in the control group,and the difference was statistically significant(P<0.05).Conclusions:The application of heat preservation nursing in the elderly patients with fracture surgery during anesthesia recovery period can improve the quality of anesthesia recovery,stabilize the levels of hemodynamic indexes,reduce the body's oxidative stress response,promote the recovery of cognitive function,and reduce the incidence of complications.Moreover,it is superior to routine nursing.