体温控制联合麻醉苏醒干预对腹腔镜全麻手术患者术后认知功能及恢复期寒颤的影响

Effects of temperature control combined with anesthesia awakening intervention on postoperative cognitive function and prevention of shivering during recovery in patients undergoing laparoscopic general anesthesia

目的 探讨体温控制联合麻醉苏醒干预对腹腔镜全麻手术患者术后认知功能及恢复期寒颤的影响。方法 选择2019年7月至2022年6月收治的腹腔镜全麻手术患者94例,根据护理干预方式不同分为对照组和观察组,每组47例。对照组给予常规干预;观察组采用体温控制联合麻醉苏醒干预,对比2组患者围术期应激反应情况。采用蒙特利尔认知评估(MoCA)和简易精神状态检查(MMSE)量表评价术前及术后2组患者的认知功能情况。比较2组患者术后寒颤情况。比较2组满意度情况。结果 术后,2组C-反应蛋白(CRP)、肾上腺素、去甲肾上腺素高于术前,对照组明显高于观察组(P<0.05);术后,2组MoCA和MMSE评分低于术前(P<0.05),对照组明显低于观察组(P<0.05);观察组寒颤分级和满意度均明显优于对照组(P<0.05)。结论 体温控制联合麻醉苏醒干预可减轻腹腔镜全麻手术患者应激反应,降低术后认知功能障碍,有效预防恢复期寒颤,利于患者术后转归。

Objective To exploring the effects of temperature control combined with anesthesia awakening intervention on postoperative cognitive function and prevention of shivering during recovery in patients undergoing laparoscopic general anesthesia.Methods A total of 94 patients receiving laparoscopic general anesthesia from July 2019 to June 2026 were selected.They were assigned into the control group and the observation group according to different interventions,with 47 cases in each group.Conventional interventions were given to patients of control group,and temperature control combined with anesthesia awakening intervention was performed in the observation group.Perioperative stress reaction was compared between groups.The Montreal Cognitive Assessment(MoCA) and the Mini Mental State Examination(MMSE) scales were used to evaluate the cognitive function of patients before and after operation.The postoperative shivering and nursing satisfaction of the two groups were compared.Results Postoperative C-reactive protein(CRP),epinephrine and norepinephrine were significantly higher than preoperative levels in both groups,which were significantly higher in the control group than those of the observation group(P<0.05).Postoperative MoCA and MMSE scores were significantly lower than preoperative levels in both groups,which were significantly lower in the control group than those of the observation group(P<0.05).After operation,the grade of shivering in the observation group was significantly better than that of the control group(P<0.05).Nursing satisfaction in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Temperature control combined with anesthesia awakening intervention can reduce the stress reaction of patients undergoing laparoscopic general anesthesia,reduce postoperative cognitive dysfunction,effectively prevent shivering during recovery,and facilitate the postoperative outcome.