以预防低体温为导向的前瞻性护理对全麻手术患者意识恢复及应激反应的影响  

Effect of prospective nursing oriented to hypothermia prevention on recovery of consciousness and stress response of general anesthesia patients in Operating

作　　者：朱玢[1] 吴春梅[1] 杨芳[1] 栗光青[1] Room Zhu Bin;Wu Chunmei;Yang Fang;Li Guangqing(Department of Anesthesia and Surgery,Shanxi Provincial People's Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院麻醉手术科,太原030012

出　　处：《中华现代护理杂志》2021年第31期4303-4307,共5页Chinese Journal of Modern Nursing

基　　金：山西省科技攻关项目(20150313011-6)。

摘　　要：目的探讨以预防低体温为导向的前瞻性护理对全麻手术患者意识恢复及应激反应的影响。方法2019年6月—2020年12月采用便利抽样法选择在山西省人民医院实施全麻手术的患者120例,根据手术时间分为对照组和观察组,各60例。对照组采用常规保温护理,观察组采用以预防低体温为导向的前瞻性护理。比较两组围手术期应激指标、苏醒质量、发生麻醉不良反应的差异。结果两组患者麻醉前、术后12 h的血清皮质醇(COR)、去甲肾上腺素(NE)水平比较,差异无统计学意义(P>0.05);手术开始30 min后、拔管后10 min时观察组血清COR、NE水平低于对照组(P<0.05)。观察组自主呼吸、意识恢复、导管拔除、麻醉后恢复室(PACU)滞留时间均短于对照组(P<0.05)。观察组麻醉不良反应总发生率低于对照组(P<0.05)。结论以预防低体温为导向的前瞻性护理可减轻全麻手术患者围手术期应激反应,提升意识恢复质量,减少麻醉不良反应。Objective To explore the effect of prospective nursing oriented to hypothermia prevention on the recovery of consciousness and stress response of general anesthesia patients in the Operating Room.Methods The convenience sampling was used to select 120 surgical patients undergoing general anesthesia in Shanxi Provincial People's Hospital from June 2019 to December 2020.According to the operation time,the patients were divided into the control group and the observation group,each with 60 cases.The control group conducted conventional heat-preservation nursing,and the observation group carried out prospective nursing oriented to hypothermia prevention.The differences in perioperative stress indicators,recovery quality,and adverse reactions of anesthesia were compared between the two groups.Results There was no significant difference in serum cortisol(COR)and norepinephrine(NE)before anesthesia and 12 hours after operation between the two groups(P>0.05).Serum COR and NE in the observation group were lower than those in the control group 30 minutes after the operation and 10 minutes after extubation,and the differences were statistically significant(P<0.05).The observation group's spontaneous breathing,recovery of consciousness,catheter removal,and Post-Anesthesia Care Unit(PACU)retention time were shorter than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions of anesthesia in the observation group was lower than that in the control group also with a statistical difference(P<0.05).Conclusions Prospective nursing oriented to hypothermia prevention can reduce the perioperative stress response of general anesthesia patients in the Operating Room,improve the quality of consciousness recovery,and reduce the adverse reactions of anesthesia.

关 键 词：全身麻醉 体温管理 低体温预防 前瞻性护理 意识恢复 应激反应 

分 类 号：R473.6[医药卫生—护理学]