多模式保温联合集束化干预措施对腹腔镜手术患者术中低体温、应激反应及康复的影响
Effect of multi-mode heat preservation combined with cluster interven-tion on intraoperative hypothermia,stress response and rehabilitation of patients undergoing laparoscopic surgery
邱玉娟 1兰晓珺 1张燕 1薛蓓 1刘敏1
作者信息
- 1. 江西省上饶市立医院手术室,江西上饶 334000
- 折叠
摘要
目的 探讨多模式保温联合集束化干预措施对腹腔镜手术患者术中低体温、应激反应及康复的影响.方法 选取2022年1月至12月上饶市立医院进行腹腔镜手术的60例患者作为研究对象,按照随机数字表法分为对照组(n=30)与研究组(n=30).对照组实施多模式积极保温护理,研究组在对照组的基础上联合低体温集束化护理策略.比较两组患者的护理满意度、体温变化(入室后10 min、气腹前10 min、术毕的同侧鼓膜温度)、应激反应[皮质醇(Cor)、肾上腺素(E)、去甲肾上腺素(NE)]、术后寒战发生率、苏醒时间、术后3d发热率及术后并发症情况.结果 研究组护理满意度高于对照组,差异有统计学意义(P＜0.05).两组气腹前10 min体温均高于本组入室后10 min,术毕时体温均高于本组气腹前10 min,差异有统计学意义(P＜0.05);两组入室后10 min、气腹前10 min体温组间比较,差异无统计学意义(P＞0.05);研究组术毕体温高于对照组,差异有统计学意义(P＜0.05).两组患者术前Cor、E、NE水平比较,差异无统计学意义(P＞0.05);研究组术后Cor、E、NE水平均低于对照组,差异有统计学意义(P＜0.05).研究组术后寒战率、术后3 d发热率、术后并发症发生率均低于对照组,差异有统计学意义(P＜0.05);研究组的苏醒时间短于对照组,差异有统计学意义(P＜0.05).结论 多模式保温联合集束化干预措施能够降低腹腔镜手术患者术中低体温发生率,降低患者应激反应程度,促进患者康复.
Abstract
Objective To explore the effects of multi-mode heat preservation combined with cluster intervention on intra-operative hypothermia,stress response and rehabilitation of patients undergoing laparoscopic surgery.Methods A total of 60 patients undergoing laparoscopic surgery in Shangrao Municipal Hospital from January to December 2022 were selected as the study objects and divided into control group(n=30)and study group(n=30)according to random number table method.The control group received multi-mode heat preservation.On the basis of the control group,the study group combined with hypothermia cluster nursing strategy.The nursing satisfaction,temperature change(10 min after entry,10 min before pneu-moperitoneum,ipsilateral tympanal temperature after operation),stress response(cortisol[Cor],epinephrine[E],nore-pinephrine[NE]),incidence of postoperative chills,recovery time,fever rate three days after surgery and postoperative com-plications were compared between the two groups.Results The nursing satisfaction of the study group was higher than that of the control group,the difference was statistically significant(P＜0.05).The body temperature of two groups before 10 min of pneumoperitoneum was higher than that of 10 min after entry,and the body temperature of two groups after operation was higher than that of 10 min before pneumoperitoneum,the differences were statistically significant(P＜0.05).There were no significant differences in body temperature between the two groups 10 min after entry and 10 min before pneumoperitoneum(P＞0.05).The body temperature of the study group was higher than that of the control group after operation,and the differ-ence was statistically significant(P＜0.05).There were no significant differences in preoperative Cor,E and NE levels be-tween the two groups(P＞0.05).The levels of Cor,E and NE in the study group were lower than those in the control group,and the differences were statistically significant(P＜0.05).The postoperative chills rate,postoperative fever rate and postop-erative complications rate of the study group were lower than those of the control group,the differences were statistically sig-nificant(P＜0.05).The recovery time of the study group was shorter than that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Multi-mode heat preservation combined with cluster intervention can reduce the incidence of intraoperative hypothermia,reduce the degree of stress reaction and promote the recovery of patients under-going laparoscopic surgery.
关键词
多模式保温/集束化护理/腹腔镜手术/术中低体温/应激反应/康复Key words
Multi-mode heat preservation/Cluster nursing/Laparoscopic surgery/Intraoperative hypothermia/Stress re-sponse/Rehabilitation引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据