充气式保温毯下肢大血管复温对乳腺癌患者术中低体温的预防效果  

Efect of forced-air-warming blanket covering the macroangiopathy of lower limb on hypothemia in patients with radical breast cancer

作　　者：胡皓琳[1] 邱云[1] Hu Haolin;Qiu Yun(Department of Operating Room,the Central Hospital of Xiangyang City,Hubei Province,Xiangyang 441021,China)

机构地区：[1]湖北省襄阳市中心医院手术室,441021

出　　处：《中国实用护理杂志》2020年第22期1740-1745,共6页Chinese Journal of Practical Nursing

摘　　要：目的探讨充气式保温毯下肢大血管复温对乳腺癌患者术中低体温的预防效果。方法选择2018年5月至2019年5月在湖北省襄阳市中心医院手术室行乳腺癌根治术的106例患者为研究对象,按照随机数字表法分为试验组和对照组各53例,对照组将充气式保温毯覆盖双侧髂前上棘连线至双足,试验组将保温毯覆盖于双侧髂前上棘连线至双膝连线之间。分别于麻醉前(T0)及麻醉诱导后30 min(T1)、60 min(T2)、90 min(T3)、120 min(T4)和术终(T5)时记录2组患者鼻咽温、心率和平均动脉压,同时比较2组患者手术前后凝血功能指标变化。结果T0和T1时2组患者鼻咽温比较差异无统计学意义(P>0.05);T2~T5时试验组鼻咽温分别为(36.41±0.61)、(36.37±0.76)、(36.20±0.94)、(36.15±1.05)℃,明显高于对照组的(36.05±0.73)、(35.84±0.76)、(35.60±0.59)、(35.57±0.53)℃,2组比较差异有统计学意义(t值为2.762~3.970,P<0.01)。术后试验组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间分别为(9.43±1.51)、(32.49±3.69)、(13.33±2.23)s,明显低于对照组的(10.48±1.81)、(34.36±4.14)、(15.38±2.43)s,纤维蛋白原、血小板计数分别为(3.58±0.83)g/L、(199.11±20.31)×10^9/L,明显高于对照组的(3.25±0.43)g/L、(176.45±16.41)×10^9/L,2组比较差异有统计学意义(t值为2.445~6.319,P<0.05或0.01)。试验组术中出血量及低体温、寒战发生率分别为(279.56±46.03)ml、5.66%(3/53)、16.33%(8/53),明显少于对照组的(318.66±74.47)ml、18.87%(10/53)、33.96%(18/53),2组比较差异有统计学意义(t值为3.251,χ^2值为4.296、4.169,均P<0.01或0.05)。结论对乳腺癌根治术患者采用充气式保温毯下肢大血管复温法,能有效预防术中低体温发生风险和减少术中出血量。Objective To explore the clinical effect of forced-air-warming blanket covering the macroangiopathy of lower limb on hypothemia of patients with radical breast cancer.Methods A total of 106 radical breast cancer patients from May 2018 to May 2019 in the Central Hospital of Xiangyang City,Hugei Province,were divided into experiment group and control group with 53 cases each,in accordance with the random number table.Forced-air-warming blanket rely on the lower half body,cover a wide range from biliateral iliac spines to feet in the control group,while those cover range from biliateral iliac spines to knee in the experiment group.The nasopharyngeal temperature,heart rate,mean arterial pressure was recorded after the patients into the operation room(T0),30 min(T1),60 min(T2),90 min(T3),120 min(T4)and at when operation was over(T5).Meanwhile,the changes of coagulation index were compared between groups before and after operation.Results There was no significant difference in nasopharynx temperature between groups at T0 and T1(P>0.05).From T2 to T5,the nasopharynx temperature was(36.41±0.61),(36.37±0.76),(36.20±0.94),(36.15±1.05)℃in the experiment group,and(36.05±0.73),(35.84±0.76),(35.60±0.59),(35.57±0.53)℃in the control group,the differences were statistically significant(t values were 2.762-3.970,P<0.01).However,the level of heart rate,mean arterial pressure was no significant difference between groups at different operation time(P>0.05).After operation,the thrombin time,activated partial thromboplastin time,prothrombin time,fibrinogen,platelet count was(9.43±1.51)s,(32.49±3.69)s,(13.33±2.23)s,(3.58±0.83)g/L,(199.11±20.31)×10^9/L in the experiment group,and(10.48±1.81)s,(34.36±4.14)s,(15.38±2.43)s,(3.25±0.43)g/L,(176.45±16.41)×10^9/L in the control group,the differences were statistically significant(t values were 2.445-6.319,P<0.05 or 0.01).Inaddition,blood loss in surgery,the incidence of hypothemia,shivering were(279.56±46.03)ml,5.66%(3/53),16.33%(8/53)in the experiment group,and(318.66�

关 键 词：充气式保温毯 大血管 乳腺癌根治术 低体温 凝血功能 

分 类 号：R473.73[医药卫生—护理学]