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老年手术患者术中低体温的护理干预分析

2023-04-29胡锦玉朱红

婚育与健康 2023年6期
关键词:低体温

胡锦玉 朱红

【摘要】目的:探讨老年手术患者伴随术中低体温采取的护理干预。方法:选取院内2021年1月—2022年9月收治的83例老年手术患者进行研究,应用随机数表法分成两组,对照组(n=41)采取常规保温护理,观察组(n=42)采取综合保温护理,对比两组患者护理效果。结果:观察组手术前体温变化无意义(P>0.05),手术开始后30min、60min、90min、手术结束后体温均优于对照组,术后Cor、BG、NE等指标均低于对照组,DASS-21评分低于对照组,差异有统计学意义(P<0.05)。结论:将综合保温护理措施应用到老年手术患者中,能够促进患者体温稳定性,可有效缓解患者应激反应,改善心理状态。

【关键词】老年手术;低体温;保温护理;应激指标

Analysis of nursing intervention of intraoperative hypothermia in elderly patients undergoing operation

HU Jinyu, ZHU Hong

Operating room,the 901th Hospital of Joint Logistics Support Force of PLA, Hefei, Anhui 230000, China

【Abstract】Objective: To explore the nursing intervention of elderly patients with intraoperative hypothermia. Methods: Eighty-three cases of elderly patients undergoing surgery in our hospital from January 2021 to September 2022 were selected for the study. Random number table method was used to divide them into two groups. The control group (n=41) took routine insulation nursing, and the observation group (n=42) took comprehensive insulation nursing, and the nursing effects of the two groups were compared. Results: There was no significant difference in body temperature in the observation group before operation (P>0.05), and body temperature 30, 60, 90min after operation and after operation was better than that in the control group. Postoperative indexes of Cor, BG, NE and DASS-21 were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion: The comprehensive insulation nursing measures applied to the elderly patients with surgery can promote the stability of the temperature of patients, can effectively relieve the stress response of patients, improve the psychological state.

【Key Words】Geriatric surgery; Hypothermia; Thermal insulation care; Stress index

体温属于生命四大体征,具有调节中枢的作用,可有效促进内分泌腺体等组织器官功能改变,进而保持散热、产热平衡,保障患者新陈代谢速率[1]。但是受到手术影响,由于身体处于暴露状态,加之环境以及麻醉状态,将会导致人体散热情况提升、产热水平下降,導致围术期低体温出现[2]。因为腹部手术需要暴露体表面积相对较大,加之老年患者在体温调节能力方面相对有限,往往具有更高的低温风险。受到低温影响,将会引发凝血功能障碍,增加患者术后感染风险,使患者手术治疗效果下 降[3]。因此,强调临床应切实加强患者保温护理工作。本文围绕老年手术患者,观察综合保温护理对改善患者术中低体温的影响。

1 资料与方法

1.1 一般资料

于本院2021年1月—2022年9月收治的老年手术患者中随机选取83例,以随机数表法分为观察组和对照组。观察组42例,男31例,女11例,年龄63~78岁,平均年龄(69.72±3.65)岁。对照组41例,男30例,女11例,年龄64~78岁,平均年龄(69.73±3.69)岁。两组患者具有可比性(P>0.05)。纳入标准:①所有患者年龄超过60岁,均同意接受腹部手术;②腹部手术时间低于5h;③患者已经对手术内容、护理内容知情。排除标准:①合并恶性肿瘤患者;②合并甲状腺功能异常患者;③在3个月内接受输血治疗患者;④存在认知障碍患者。

1.2 方法

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