全程闭环体温管理对股骨颈骨折患者围手术期的干预效果分析

Observation on the Effect of Whole Process Closed Loop Temperature Management Applied to the Perioperative in Patients with Neck of Femur Fracture

目的:探讨全程闭环体温管理对股骨颈骨折患者围手术期的干预效果分析。方法:选择2020年6月-2022年5月天津医院收治的91例股骨颈骨折患者为研究对象,按照计算机分组法分为对照组(n=45)和观察组(n=46)。对照组采用常规体温监测管理,观察组采用全程闭环体温管理。观察2组术中失血量、术后恢复情况、不同时间核心体温变化、凝血指标水平及围手术期不良反应发生率。结果:观察组术中失血量均低于对照组,差异有统计学意义(P<0.05)。观察组清醒、拔管所需、麻醉恢复室(PACU)滞留时间均短于对照组,组间差异有统计学意义(P<0.05)。切皮时、手术结束时,2组体温均降低,但观察组高于对照组,差异有统计学意义(P<0.05);出PACU时,观察组体温高于对照组,差异有统计学意义(P<0.05)。术后,2组凝血酶时间、凝血酶原时间及活化部分凝血活酶时间均降低,但观察组比对照组高,差异有统计学意义(P<0.05)。观察组低体温、寒颤、躁动发生率低于对照组,差异有统计学意义(P<0.05)。结论:对股骨颈骨折患者实施全程闭环体温管理,有利于维持核心体温,改善凝血功能,减少术中失血量,从而降低术后低体温、寒颤、躁动发生率,促进术后恢复。

Objective:To explore the clinical nursing effect of the whole process closed-loop temperature management on patients with neck of femur fracture.Methods:91 patients with neck of femur fracture admitted in Tianjin hospital from June 2020 to May 2022 were selected and divided into a control group(n=45)and an observation group(n=46)according to the computer grouping method.The control group was given routine temperature monitoring management,and the observation group was given full closed-loop temperature management.The intraoperative blood loss,postoperative recovery,core temperature changes at different times,blood coagulation index levels,and the incidence of perioperative adverse reactions were observed in the two groups.Results:The intraoperative blood loss in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).The time of awakening,extubation,and postanesthesia care unit(PACU)retention in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).At the time of skin incision and the end of surgery,the body temperature of both groups decreased,but the observation group was higher than the control group,the differences were statistically significant(P<0.05).When leaving PACU,the body temperature of both groups increased,and the observation group was higher than the control group,the differences were statistically significant(P<0.05).The thrombin time,prothrombin time and activated partial thromboplastin time in both groups decreased,but those in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).The incidence of hypothermia,chills,and restlessness in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:The whole process closed-loop temperature management for patients with neck of femur fracture is conducive to maintaining core temperature,improving coagulation function,reducing intraoperative blood loss,thus reducing the incidence of postoperative hypothermia,shivering,restlessness,and promoting postoperative recovery.