全麻患者术中低体温临床结局及其护理预防策略研究  

Study on clinical outcome of intraoperative hypothermia in general anesthesia patients and its nursing prevention strategies

作　　者：李小英[1] 张红[1] 吴莉娜[1] 钞海莲[1] 马霞 高明姬[1] 于晓倩 LI Xiaoying;ZHANG Hong;WU Lina;CHAO Hailian;MA Xia;GAO Mingji;YU Xiaoqian(Department of Anesthesia Surgery,Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学第二附属医院麻醉手术科,西安710004

出　　处：《长春中医药大学学报》2021年第1期153-156,共4页Journal of Changchun University of Chinese Medicine

基　　金：社会发展科技攻关项目(2016SF-152)。

摘　　要：目的本研究旨在探讨全身麻醉患者术中低体温的临床结局及其护理预防策略。方法本研究为回顾性研究,纳入了2014年11月-2019年8月在我院接受全麻手术的患者3132例。护理工作中应该采取有效的预防策略,包括转运过程中主动保暖,液体加温,静脉输液及手术间预热至24℃,并根据术中情况调节适宜的室温;主动加温技术液制品加温至37℃,麻醉诱导前30~60 min应用充气式加温毯实施预保温,入室前将手术,术中持续应用调至38℃档的充气式加温毯实施主动加温等,降低术中低体温的发生率。结果术中低体温的总体发生率为44.3%。与未发生术中低体温的患者相比较,发生了术中低体温的患者术后寒战和收入ICU的比例更高,PACU时间更长,术后住院天数更多(均P<0.05);手术部位感染率和术后30 d死亡率编辑,差异无统计学意义(均P>0.05)。结论我院术中低体温的发生率较高,主动升温手术期间患者的比例很低。术中低体温增加术后寒战发生率,增加ICU入院率,并延长术后住院天数。护理工作中应该采取有效的预防策略,降低术中低体温的发生率。Objective To investigate clinical outcomes of intraoperative hypothermia in patients with general anesthesia and corresponding nursing prevention strategies.Methods The study,a retrospective one,involved 3,132 patients undergoing general anesthesia in our hospital from November 2014 to August 2019.In order to reduce the incidence rate of intraoperative hypothermia,the following effective nursing prevention strategies should be taken:active warming of patients during transit,liquid heating,intravenous infusion of liquid and blood preheating to 24℃,and adjusting the appropriate room temperature according to the operation condition;heating liquid products to 37℃with active heating technology,pre-warming with an inflatable heating blanket 30-60 min before anesthesia induction,continuously using an inflatable heating blanket adjusted to 38℃for active heating before entering the operating room and during the operation,etc.Results The overall incidence rate of intraoperative hypothermia was 44.3%.Patients with hypothermia comparatively had a higher proportion of postoperative shivering and admission to ICU,longer PACU time and more postoperative hospital stays(all P<0.05),but there was no significant difference in both infection rate of surgical site and mortality rate within 30 days after surgery(both P>0.05).Conclusion The incidence rate of intraoperative hypothermia in our hospital used to be relatively high.Comparatively,the proportion of intraoperative hypothermia patients with active warming nursing strategy gets very low.Intraoperative hypothermia may increase the incidence rate of postoperative shivering,ICU admission rate,and prolong postoperative hospital stay.Therefore effective nursing prevention strategies are proposed to be adopted to reduce its incidence.

关 键 词：全身麻醉 术中低体温 临床结局 护理预防策略 

分 类 号：R473.6[医药卫生—护理学]