充气式加温毯对老年胃癌根治术患者术后体温及炎症因子的影响  

Effect of Inflatable Warming Blanket on Body Temperature and Inflammation Level in Elderly Patients with Radical Gastric Cancer

作　　者：唐成菊[1] 刘亚 张臣艳 TANG Chengju;LIU Ya;ZHANG Chenyan(Department of Hepatobiliary Surgery, Sanxia Central Hospital ,Chongqin 404000,China;Department of Gastro Haematology, Sanxia Central Hospital;Department of Operation Room. Chongqing Wanzhou District Hospital of traditional Chinese Medicine, Chongqin 404000,China)

机构地区：[1]重庆三峡中心医院肝胆外科,重庆404000 [2]重庆三峡中心医院胃甲血科 [3]重庆市万州区中医院手术室,重庆404000

出　　处：《解放军护理杂志》2019年第5期51-53,57,共4页Nursing Journal of Chinese People's Liberation Army

摘　　要：目的探讨充气式加温毯对老年胃癌根治术患者术后体温及炎症因子的影响。方法便利抽样选择2015年9月至2017年9月符合条件的145例老年胃癌患者为研究对象.随机分为研究组72例和对照组73例。对照组术中给予常规保温法,研究组术中给予充气式加温毯保温,于麻醉前和手术结束后即刻测量鼓膜温度。手术前1d利手术结束后24 h抽取静脉血检测肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)并采用简易智力状态检查表(mini-mental state examination, MMSE)进行认知障碍评估。结果研究组20例(27.8%)术后出现低体温,低于对照组(49例,67. 1%);研究组术后IL-6、TNF-α水平低于对照组.差异均有统计学意义(P<0. 05)。研究组和对照组术后认知功能障碍(postoperative cognitive dysfunction, POCD)发生率分别为34.2%(25例)和19.4%(14例),两组比较差异有统计学意义(χ^2=4. 039,P =0. 044)。结论应用充气式加温毯有助于老年胃癌根治术患者术中体温的稳定性降低炎症因子水平,并进而降低术后POCD的发生率,值得在临床中进一步推广应用。Objective To explore the effect of inflatable warming blanket on early postoperative cognitive dysfunction (POCD) and inflammation level in elderly patients with radical gastrectomy. Methods By convenience sampling method, 145 eligible elderly patients with gastric cancer from September 2015 to September 2017 were selected and randomly divided into the study group (72 cases) and the control group (73 cases). The control group was given routine heat preservation care during the operation, while the study group was given inflatable warming blanket during the operation. The temperature of tympanic membrane was measured immediately before and after anesthesia. Venous blood was collected for detection of tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) on the first day before operation and 24 h after the operation. Mini-mental state examination was used to assess cognitive impairment. Results In the study group,20 cases (27. 8%) had hypothermia after the operatiowhich was lower than that in the control group (49 cases,67. 1%). The levels of IL-6 and TNF-α in the study group were significantly lower than those in the control group (P<0. 05). There was 34. 2%(25 cases) and 19. 4%(14 cases) of POCD in the study group and the control group, respectively. There was significant difference between the two groups (χ^2= 4. 039, P = 0. 044). Conclusions The application of inflatable warming blanket can reduce the incidence of POCD and the level of inflammatory factors in elderly patients with gastric cancer after radical operation. It is worth further developing in clinical practice.

关 键 词：充气式加温毯 胃癌 炎症因子 体温 老年 术后认知功能障碍 

分 类 号：R473.6[医药卫生—护理学]