术中综合保温干预对老年骨折患者出血、体温、凝血功能的影响

Effects of intraoperative comprehensive thermal insulation intervention on bleeding,body temperature,coagulation function in the elderly with fracture

目的探讨老年骨折患者给予术中综合保温干预对患者出血、体温、凝血功能的影响。方法选取2020年1月至2021年6月收治的老年骨折患者84例,随机分2组,每组42例,对照组和观察组分别采用常规干预和术中综合保温干预,比较2组的出血量、体温、凝血功能和焦虑、抑郁评分及护理满意度、并发症发生率。结果观察组的术中出血量少于对照组,观察组手术中的体温高于对照组(P<0.05)。对照组干预后的纤维蛋白原(Fbg)水平高于干预前,凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、凝血酶时间(TT)水平低于干预前(P<0.05);观察组干预后的PT、aPTT、Fbg、TT水平与干预前相比,无显著差异(P>0.05),观察组的上述各凝血功能指标水平均优于对照组(P<0.05)。2组干预后的焦虑、抑郁评分低于干预前,且观察组低于对照组(P<0.05)。观察组的护理满意度为95.23%,高于对照组的76.19%(P<0.05)。观察组的术后并发症发生率为21.43%,低于对照组的2.38%(P<0.05)。结论给予老年骨折患者术中综合保温干预,可减少患者术中出血量,维持患者术中体温温度和凝血功能正常,缓解其焦虑、抑郁情绪,减少术后并发症,促进患者护理满意度提高。

Objective To explore the effects of intraoperative comprehensive thermal insulation intervention on bleeding,body temperature,coagulation function in elderly patients with fracture.Methods Totally 84 the elderly with fracture admitted to our hospital from January 2020 to June 2021 were randomly assigned to control group(n=42)and observation group(n=42),in which they were given routine intervention and intraoperative comprehensive thermal insulation intervention,respectively.The amount of bleeding,body temperature,coagulation function,scores of anxiety and depression,nursing satisfaction,incidence of complications were compared between the two groups.Results The intraoperative bleeding in the observation group was significantly less than that in the control group,while the intraoperative body temperature was significantly higher than that in the control group(P<0.05).After intervention,the levels of fibrinogen(Fbg)in the control group were significantly higher than before intervention,while the levels of prothrombin time(PT),activated partial thromboplastin time(aPTT),and thrombin time(TT)were significantly lower(P<0.05).None of the levels of PT,aPTT,Fbg,and TT differed significantly in the observation group before and after intervention(P>0.05).The levels of PT,aPTT,Fbg,and TT in the observation group were significantly better than those in the control group(P<0.05).After intervention,the scores of anxiety and depression in the both groups were significantly decreased(P<0.05),which decreased notably in the observation group compared with the control group(P<0.05).The nursing satisfaction in the observation group was significantly higher than that in the control group(95.23%vs 76.19%,P<0.05).The incidence of complications was significantly lower in the observation group compared to the control group(2.38%vs 21.43%,P<0.05).Conclusion The intraoperative comprehensive thermal insulation intervention in the elderly with fracture can reduce intraoperative bleeding,maintain intraoperative normal body temperature and coagulation function,relieve anxiety and depression,reduce postoperative complications,and improve nursing satisfaction.