术中保温护理在髋关节置换术患者中的应用效果观察

Observation on the Effect of Intraoperative Thermal Insulation Nursing in Patients with Hip Replacement

目的:观察术中保温护理在髋关节置换术患者中的应用效果。方法:选取2021年5月—2022年4月于桂林医学院第二附属医院行髋关节置换术的患者96例为研究对象,采用随机数字表法分为对照组和观察组,各48例。对照组给予术中常规护理,观察组在对照组基础上给予术中保温护理。比较两组进入手术室后(T_(1))、麻醉诱导后(T_(2))、麻醉30 min(T_(3))、手术60 min(T_(4))、手术90 min(T_(5))及手术结束即刻(T6)的鼻咽部温度,手术前后应激反应[去甲肾上腺素(NE)、C反应蛋白(CRP)及肾上腺素(AD)]水平及术后并发症发生情况。结果:T_(1)、T_(2),两组鼻咽部温度比较,差异无统计学意义(P>0.05);T_(3)~T6,两组鼻咽部温度下降,观察组高于对照组,差异有统计学意义(P<0.05)。术前,两组NE、CRP、AD水平比较,差异无统计学意义(P>0.05);术后,两组NE、CRP、AD水平升高,观察组低于对照组,差异有统计学意义(P<0.05)。两组术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论:术中保温护理在髋关节置换术患者中的应用效果显著,可稳定患者术中体温,降低应激水平,且未增加术后并发症发生风险。

Objective:To observe the effect of intraoperative thermal insulation nursing in patients with hip replacement.Methods:A total of 96 patients who underwent hip replacement in the Second Affiliated Hospital of Guilin Medical University were selected as the study objects from May 2021 to April 2022,and were divided into control group and observation group by random number table method,with 48 cases in each group.The control group received routine nursing during operation,and the observation group received thermal insulation nursing based on the control group.The nasopharyngeal temperature after the operating room(T_(1)),after anesthesia induction(T_(2)),30 min of anesthesia(T_(3)),60 min of surgery(T_(4)),90 min of surgery(T_(5))and immediately after surgery(T6),The levels of stress response[norepinephrine(NE),C-reactive protein(CRP)and epinephrine(AD)]before and after surgery and the incidence of postoperative complications were compared between the two groups.Results:There was no significant difference in nasopharyngeal temperature between T_(1) and T_(2) groups(P>0.05).T_(3)~T6,nasopharyngeal temperature of 2 groups decreased,observation group was higher than control group,the difference was statistically significant(P<0.05).Before operation,there was no significant difference in NE,CRP and AD levels between the two groups(P>0.05);after operation,the levels of NE,CRP and AD in the two groups were increased,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).There was no significant difference in the total incidence of postoperative complications between the two groups(P>0.05).Conclusion:Intraoperative thermal insulation nursing is effective in patients with hip replacement,which can stabilize the intraoperative body temperature,reduce the stress level,and do not increase the risk of postoperative complications.