开腹手术患者术中保温方法的探讨  

Methods of thermal incubation on abdominal surgery

作　　者：贾风菊[1] 李丽[1] 孙奇 邵丽[1] 

机构地区：[1]新疆医科大学第一附属医院手术室,乌鲁木齐830054 [2]新疆维吾尔自治区中医医院医学研究设计与数据处理中心,乌鲁木齐830000

出　　处：《中华现代护理杂志》2016年第10期1362-1366,共5页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金资助项目（81360082）

摘　　要：目的：探讨开腹手术患者术中使用多种不同的保温方法对患者体温的影响。方法选择2014年1—12月普外科择期开腹手术患者160例,采用输液加温、身体包裹、湿敷料加温、冲洗液加温、保温毯使用等保温方法,监测并记录患者从入室至手术结束时鼻咽温度和直肠温度。本研究为前瞻性研究,采用析因设计方案：5因素2水平共25次即32种组合,每种组合重复5次。结果输液加温＋冲洗液加温＋保温毯使用组的鼻咽温度为（36.94±0.22）℃,直肠温度为（37.32±0.13）℃,保温效果最好；其次是单用保温毯组,鼻咽温度为（36.90±0.37）℃,直肠温度为（37.26±0.26）℃,保温效果次之；第三是输液加温＋身体包裹组,鼻咽温度为（36.48±0.36）℃,直肠温度为（36.82±0.40）℃；差异均有统计学意义（P〈0.01）。结论开腹手术患者术中实施保温护理措施比较如下：输液加温＋冲洗液加温＋保温毯使用保温方法为最优选择,其次为单用保温毯的保温方法,再次为输液加温＋身体包裹保温方法的组合。保证手术患者的安全,积极维持患者正常体温,是手术室护士实施优质护理措施的必要之举。Objective To explore the influences of intraoperative warming methods on body temperature of open abdominal surgery patients. Methods Intraoperative warming methods, which included warming of intravenous infusion or moist dressing or flushing fluids, body wrapping and used insulation blankets, were implemented to 160 elective open abdominal surgery patients from January to December of 2014. Nasopharyngeal and rectal temperatures were monitored from induction to end of surgery. In this prospective study, 5 factors 2 levels were total 25 times （ 32 groups ） combination and each combination repeated 5 times. Results The insulation effect was the best in the combination of intravenous infusion warming, flushing fluids warming and insulation blanket using group with nasopharyngeal temperature （ 36. 94 ± 0. 22 ）℃ and rectal temperature （37. 32 ± 0. 13 ）℃; the effect of insulation blanket followed as second with nasopharyngeal temperature （36. 90 ± 0. 37）℃ and rectal temperature （37. 26 ± 0. 26）℃; intravenous infusion warming in combination with body wrapping keeping nasopharyngeal temperature （36. 48 ± 0. 36）℃ and rectal temperatures （36. 82 ± 0. 40）℃was the third best combination in all the tested groups;the differences were statistically significant （P〈0. 01）. Conclusions Differences of intraoperative warming methods are compared and summarized in open abdominal surgery patients as follows： intravenous infusion ＆amp; flushing fluids warming plus insulation blanket is the best choice for patient insulation during surgery. Insulation blanket and intravenous infusion warming plus body wrapping are the second and third best option for insulation. Actively maintaining intraoperative body temperature to ensure safety of patients is the necessary measure for practicing high quality surgery nursing.

关 键 词：全身麻醉 开腹手术 术中保温 体温监测 

分 类 号：R473.6[医药卫生—护理学]