摘要
目的 探讨腔镜辅助下根治手术的老年胃癌患者手术中应用不同保温温度对于体温保护的效果,及对血凝、应激及术后不良反应的影响.方法 将2013年5月—2015年5月在泰州市人民医院麻醉科行择期腔镜辅助下根治手术的101例老年胃癌患者依据随机数表法随机分为三组,分别为低温组（37℃,n=31）、高温组（45℃,n=37）和综合组（45℃,1 h后调至37℃,n=33）.比较三组患者的基线临床资料、不同时间点鼻咽温度、血凝及应激指标、术中、术后不良反应.结果 三组患者鼻咽温度、凝血酶原时间的分组与时间交互效应、组间效应、时间效应差异均有统计学意义（P〈0.05）.三组患者的皮质醇交互效应和时间效应差异有统计学意义（P〈0.05）,但组间干预效应差异无统计学意义（P〉0.05）;三组的血小板计数、胰岛素的交互效应差异无统计学意义（P〉0.05）,时间和组间效应差异有统计学意义（P〈0.05）;部分凝血酶原时间、血糖的交互效应和组间效应差异无统计学意义（P〉0.05）,时间效应差异有统计学意义（P〈0.05）.低温组患者的低体温、寒战、躁动、心血管事件及清醒时间均高于其他两组（P〈0.05）,高温组患者的发热、躁动及清醒时间高于综合组患者（P〈0.05）.结论 综合组保温策略（45℃,1 h后调至37℃）可有效地维持患者围术期体温,保护患者的凝血功能,减轻应激反应,降低术后不良反应发生率.
Objective To explore the effect of different preservation temperature on body temperature protection, blood coagulation function, stress reaction and postoperative adverse reactions during patients undergoing radical gastric cancer surgery assisted with endoscopy.Methods A total of 101 patients undergoing elective endoscopic assisted radical gastric cancer surgery in Taizhou People＇s Hospital from May 2013 to May 2015 were recruited and randomly divided into three groups according to random number table： low temperature group （37 ℃,n=31）, high temperature group （45 ℃,n=37） and combined group （45 ℃, and turn to 37 ℃ after 1 hour,n=33）. The baseline clinical data, nasopharyngeal temperatures at different time points, blood coagulation and stress index, intraoperative and postoperative adverse reactions among the three groups were compared.Results There were significant differences in nasopharyngeal temperature and prothrombin time （PT） in terms of grouping and time interaction effect, inter group effect and time effect among the three groups （P〈0.05）.The interaction and time effect of patients＇ cortisol in the three groups have significant differences （P〈0.05）, however there was no significant difference in inter group effect （P〉0.05）. There was no statistical difference among the three groups of platelet counts and insulin interactions （P〉0.05）, but the inter group and time effect difference was significant （P〈0.05）. There was no statistical significant difference of partial prothrombin time （PPT） and blood glucose （P〉0.05）, but the time effect difference was significant （P〈 0.05）. The incidence of hypothermia, chills, restlessness, cardiovascular events and awake time of patients in low temperature group were significantly higher than the other two groups （P〈0.05）. High temperature group patients had a higher incidence of fever, restlessness and awake time than the combined group （P〈 0.05）.Conclusions The preservation strategy of combined group could effectively maintain perioperative body temperature, blood coagulation function, reduce stress reaction and incidence of postoperative adverse reactions.
出处
《中华现代护理杂志》
2018年第1期102-106,共5页
Chinese Journal of Modern Nursing
关键词
胃肿瘤
围手术期护理
温度
凝血功能
应激
不良反应
Stomach neoplasms
Perioperative nursing
Temperature
Coagulation
Stress
Adverse reaction
作者简介
通信作者：崔丽丽，Email：cuililitg@126．com
