低体温干预在机器人手术患者围术期的应用效果  

Effect of hypothermia intervention on robotic surgery patients during perioperative period

作　　者：董薪[1] 陈秀梅 金莉[1] 管春丽[1] 何丽[1] DONG Xin;CHEN Xiu-mei;JIN Li;GUAN Chun-li;HE Li(Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院麻醉手术中心,北京100853 [2]北京房山区良乡医院手术室,北京102488

出　　处：《中华医院感染学杂志》2018年第20期3156-3159,共4页Chinese Journal of Nosocomiology

基　　金：解放军总医院临床科研扶持基金资助项目(22012FC-ZHCG-2003)

摘　　要：目的探讨低体温预防护理在机器人手术患者围术期的应用效果。方法选取2016年1月-2017年12月于医院接受机器人手术治疗的妇产科手术患者60例为研究对象,随机分为对照组和试验组,每组30例。对照组患者采取常规护理;试验组在对照组的基础上实施低体温干预护理保暖措施。比较手术过程中两组患者的体温变化情况及并发症发生情况。结果试验组患者气腹后30min后各时间点体温均高于对照组(P<0.05);试验组患者围术期发生寒颤、苏醒延迟均为3.33%(1/30);对照组发生寒颤40.00%(12/30),苏醒延迟23.33%(7/30),试验组发生不良反应2例少于对照组19例(P<0.001);试验组术后切口延时愈合1例、发热感染1例少于对照组8例、8例(P<0.05)。结论低温预防护理应用于机器人手术中,有利于维持体温恒定,有效预防和减少围手术期低体温的发生,减少手术部位感染,降低术后并发症,对于患者术中保温及术后恢复有着积极的促进作用,具有一定的临床价值。OBJECTIVE To explore the effect of hypothermia prevention nursing in perioperative period of robotic operation,and to reduce the infection of surgical sites.METHODS 60 patients underwent gynecological surgery during Jan. 2016-Dec. 2017 in our hospital were randomly divided into experimental group and control group,30 cases in each group.The patients in the control group received routine nursing,whereas the experimental group of patients received nursing care of hypothermia intervention in addition to routine nursing.The changes of body temperature and the incidence of complications were analyzed in the two groups during operation.RESULTS The body temperatures of the experimental group were significantly higher than those of the control group after the pneumoperitoneum for more than 30 min（P〈0.05）.There were 1 case（3.33%）of shivering and awakening delay in the experimental group,whereas 12 cases of shivering（40.00%）and 7 cases of awake delay（23.33%）in the control group.There were 2 cases of adverse reactions in the experimental group,and 19 cases in the control group（P〈0.001）.There was 1 case each of delayed wound healing after operation and infection with fever in the experimental group,whereas the case numbers in the control group were 8 and 8,respectively（P〈0.05）.CONCLUSION Applictaion of hypothermia prevention nursing in robotic surgery is beneficial for maintaing body temperature,and can efficient prevent and reduce occurrence of perioperative hypothermia,reducing the incidence of operative site infection and postoperative complications,and thus has positive promoting effect on postoperative heat preservation and postoperative recovery of patients.The nursing quality of perioperative period was further improved.

关 键 词：机器人手术 体温 预防护理 手术部位感染 

分 类 号：R183[医药卫生—流行病学]