不同术中保温法对腹部手术患者凝血功能与麻醉复苏时间及术后并发症的影响  

Effect of different intraoperative heat preservation methods on coagulation function,anesthesia resuscitation time and postoperative complications of patients undergoing abdominal operation

作　　者：刘闪闪[1] 舒惠萍[1] 胡敏花[1] LIU Shan-shan;SHU Hui-ping;HU Min-hua

机构地区：[1]中山市人民医院麻醉科,中山市528403

出　　处：《护理实践与研究》2020年第15期115-118,共4页Nursing Practice and Research

摘　　要：目的探讨不同术中保温法对腹部手术患者凝血功能与麻醉复苏时间及术后并发症的影响。方法选择2019年5-10月在本院进行腹部手术的276例患者为研究对象,按照随机数表法将患者分为A,B,C,D,E 5组,A组采用保温毯+冲洗液加温+输液输血加温;B组采用身体包裹+输液输血加温;C组采用保温毯;D组采用身体包裹;E组采用常规保温。记录患者麻醉苏醒时间,采用免疫比浊法检测患者手术前后纤维蛋白原(FIB)、凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)水平;采用放射免疫法检测患者手术前后肾上腺素(AD)、去甲肾上腺素(NE)水平;采用免疫透射散射浊度法检测患者手术前后C-反应蛋白(CRP)水平,同时记录患者麻醉恢复期躁动、寒战、心律失常发生情况。结果A组患者麻醉苏醒时间为[51.86(13.57)]min,B组为[57.44(14.06)]min,C组为[70.99(20.11)]min,D组为[72.54(21.43)]min,E组为[78.69(30.28)]min,差异有统计学意义(P<0.05)。A,B组患者麻醉苏醒时间分别短于C,D,E组,差异有统计学意义(P<0.05),但是A和B,C、D和E之间比较差异无统计学意义(P>0.05)。手术前5组患者NE,AD,CRP水平比较差异无统计学意义(P>0.05);手术后5组患者NE,AD,CRP水平均升高,差异有统计学意义(P<0.05),其中,E组NE,AD,CRP水平最高,A组最低,差异有统计学意义(P<0.05)。手术前5组患者FIB,TT,PT,APTT比较差异无统计学意义(P>0.05);手术后A组FIB,TT,PT,APTT与手术前相比差异无统计学意义(P>0.05),其余4组FIB,TT,PT,APTT均升高,差异有统计学意义(P<0.05);A组和B组FIB,TT,PT,APTT水平均低于C组、D组和E组,A组最低,E组最高,差异有统计学意义(P<0.05)。由A组至E组,躁动、寒战、心律失常发生率逐渐增高,其中E组躁动、寒战、心律失常发生率最高,A组最低,差异有统计学意义(P<0.05)。结论保温毯+冲洗液加温+输液输血加温法能明显缩短腹部手术患者麻醉苏醒时间,降低患�Objective To explore the effect of different intraoperative heat preservation methods on coagulation function,anesthesia resuscitation time and postoperative complications of patients undergoing abdominal operation.Methods To select 276 cases of patients who underwent abdominal operation in our hospital from May to October 2019 as the study objects,and the patients were divided into 5 groups A,B,C,D,E according to the random number table method,and the A group used thermal insulation blanket+washing fluid heating+infusion and blood transfusion for heating,group B used body wrapping+infusion and blood transfusion for heating,group C used thermal insulation blanket,group D used body wrapping,and group E used conventional thermal insulation.the patient’s awakening time from anesthesia was recorded,the immunoturbidimetric method was used to detect the patient’s fibrinogen(FIB),thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)levels before and after the operation,the radioimmunoassay method was used to detect the patient’s adrenaline(AD)and norepinephrine(NE)levels before and after the operation,and the immune transmission turbidity method was used to detect the patient’s C-reactive protein(CRP)level before and after the operation,at the same time,the occurrence dynamics of patient’s restlessness,chills,and arrhythmia during the recovery period from anesthesia were recorded.Results The awakening time from anesthesia in group A was[51.86(13.57)]min,group B was[57.44(14.06)]min,group C was[70.99(20.11)]min,group D was[72.54(21.43)]min,and group E was[78.69(30.28)]min,and the differences were statistically significant(P<0.05).The awakening time of patients in groups A and B was shorter than that in groups C,D,and E,and the differences were statistically significant(P<0.05),but there was no statistically significant difference among A and B,C,D and E(P>0.05).There was no significant difference in levels of NE,AD and CRP between the five groups before the operation(P>0.05).After o

关 键 词：腹部手术 保温方法 凝血功能 术后并发症 麻醉复苏时间 

分 类 号：R472.3[医药卫生—护理学]