经胸腔镜肺癌根治手术病人术中体温变化的多中心回顾性研究  

A multicentre retrospective study of intraoperative temperature changes in patients undergoing thoracoscopic radical resection of lung cancer

作　　者：黄立峰[1] 陆张力[1] 钱磊[1] 朱秋燕 陈笑笑[3] HUANG Lifeng;LU Zhangli;QIAN Lei;ZHU Qiuyan;CHEN Xiaoxiao(The Second Affiliated Hospital of Zhejiang University Medical College,Zhejiang 310009 China)

机构地区：[1]浙江大学医学院附属第二医院,浙江310009 [2]中国科学院大学附属肿瘤医院(浙江省肿瘤医院) [3]浙江大学医学院附属第一医院

出　　处：《护理研究》2021年第24期4390-4393,共4页Chinese Nursing Research

基　　金：浙江省医药卫生科技计划项目,编号:2020KY581。

摘　　要：目的:分析胸腔镜肺癌根治手术(VATS)病人术中体温变化的规律,为合理制定护理干预策略提供循证依据。方法:收集3所三级甲等医院2018年1月—2020年9月符合研究要求的病例数据,绘制VATS病人术中体温变化曲线,对影响体温降低速率的各类因素进行单因素分析。结果:手术开始3 h内,体温变化曲线依据下降速率分为3个时相,整体呈横"∫"型曲线。个体因素对于体温下降速率变化的影响没有统计学意义。结论:VATS病人术中体温下降速率随手术时间动态变化,可能与体温调节的代偿和失代偿相关;病人个体差异对于术中体温下降速率没有影响;护理人员应在最佳干预时间窗内(手术开始的60 min以内)对所有VATS病人采取有效的干预措施,预防其发生术中低体温。Objective:To explore the regulation of body temperature change during surgery in patients with video-assisted thoracic surgery(VATS)for lung cancer,and to provide evidence-based basis for the rational formulation of nursing intervention strategy.Methods:By retrospectively collecting the case data that met the requirements of the study from January 2018 to September 2020 in 3 level A hospitals,the curve of intraoperative body temperature change in VATS patients was drawn,and various factors affecting the rate of hypothermia were analyzed by univariate analysis.Results:Within 3 hours after the operation,the temperature change curve was divided into 3 phases according to the rate of decline,and the whole curve showed a horizontal "integral" type.Individual factors had no statistical significance for the change in the rate of hypothermia.Conclusion:The rate of intraoperative hypothermia in VATS patients changes dynamically with operation time,which may be related to the compensatory and decompensatory mechanisms of thermoregulation.Patients’ individual differences had no effect on the rate of perioperative hypothermia.Nursing staff should take effective intervention measures to prevent the occurrence of intraoperative hypothermia for each VATS patient within the optimal intervention time window(within 60 min of the start of the operation).

关 键 词：胸腔镜 肺癌 手术 体温 护理 

分 类 号：R473.73[医药卫生—护理学]