老年患者全髋关节置换术中低体温预防护理对围术期出血量、凝血功能及应激反应的影响  

Effects of hypothermia preventive nursing on perioperative blood loss,coagulation function and stress response in elderly patients undergoing total hip replacement

作　　者：袁映红 宋慧敏 林英 伍建容[3] 肖东琴 Yuan Yinghong;Song Huimin;Lin Ying;Wu Jianrong;Xiao Dongqin(Department of Orthopedics,Central Hospital of Nanchong City,Nanchong,Sichuan,637000,P.R.China;Operating Room,Central Hospital of Nanchong City,Nanchong,Sichuan,637000,P.R.China;Department of Stomatology,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan,637000,P.R.China;Institute of Tissue Engineering and Stem Cell Research,Central Hospital of Nanchong City,Nanchong,Sichuan,637000,P.R.China)

机构地区：[1]南充市中心医院骨科,四川南充637000 [2]南充市中心医院手术室,四川南充637000 [3]川北医学院附属医院口腔科,四川南充637000 [4]南充市中心医院组织工程与干细胞研究所,四川南充637000

出　　处：《老年医学与保健》2023年第1期100-104,共5页Geriatrics & Health Care

基　　金：四川省卫生厅科研项目(17PJ194);南充市市校合作科研项目(19SXHZ0363);南充市社会科学研究“十三五”规划项目(NC2018B056)。

摘　　要：目的分析手术中低体温预防处理对老年患者全髋关节置换术出血量、凝血功能及应激反应的影响。方法选取南充市中心医院于2017年12月—2021年12月收治的128例老年全髋关节置换术患者作为研究对象,按术中护理方式不同,将术中常规护理予以对照组,术中低体温预防护理予以观察组,每组64例患者,观察比较2组术前术中体温、术中出血量、术前后凝血功能情况、术前与术后应激反应及护理满意度。结果(1)观察组患者术中体温较对照组术中体温高[(36.42±0.41)℃vs(34.46±1.02)℃],且观察组患者术中出血量明显少于对照组患者术中出血量[(104.12±6.15)mL vs(163.84±13.11)mL](P<0.05)。(2)对照组术后Fbg水平较术前升高,PT、TT、APTT水平较术前降低;观察组术后Fbg水平较对照组低,PT、TT、APTT水平较对照组高(P<0.05)。(3)对照组术后NE、CRP及AD较术前明显升高,而观察组术后NECRP及AD明显低于对照组(P<0.05)。(4)观察组患者总护理满意度高于对照组患者(100.00%vs 87.50%)(P<0.05)。结论手术中低体温预防护理可有效保证患者凝血功能,减少患者术中出血量,降低术中应激反应的出现概率,对老年全髋关节置换患者具有积极护理作用。Objective To analyze the effects of hypothermia preventive nursing during operation on blood loss,coagulation function and stress response in elderly patients undergoing total hip replacement.Methods 128 elderly patients undergoing total hip replacement surgery in Central Hospital of Nanchong City from December 2017 to December 2021 were selected as the research subjects.According to different intraoperative nursing methods,the patients receiving routine intraoperative nursing were included in the control group,and others receiving intraoperative hypothermia preventive nursing were included in the observation group.There were 64 patients in each group.The preoperative and intraoperative body temperature,intraoperative blood loss,preoperative and postoperative coagulation function,preoperative and postoperative stress response and nursing satisfaction of the two groups were observed and compared.Results(1)The intraoperative temperature of the observation group was higher than that of the control group[(36.42±0.41)℃vs(34.46±1.02)℃]and the intraoperative blood loss of the observation group was significantly lower than that of the control group[(104.12±6.15)mL vs(163.84±13.11)mL](P<0.05).(2)In the control group,the level of postoperative Fbg was higher than that before operation,and the levels of postoperative PT,TT and APTT were lower than those before operation.The level of postoperative Fbg of the observation group was lower than that of the control group,and the levels of postoperative PT,TT,APTT were higher than those of the control group(P<0.05).(3)The levels of postoperative NE,CRP and AD of the control group were significantly higher than those before operation,while the levels of postoperative NE,CRP and AD of the observation group were significantly lower than those of the control group(P<0.05).(4)The total nursing satisfaction of patients in the observation group was higher than that in the control group(100.00%vs 87.50%)(P<0.05).Conclusion The hypothermia preventive nursing during operation can ef

关 键 词：老年 全髋关节置换术 应激反应 低体温预防 出血量 凝血功能 

分 类 号：R473.6[医药卫生—护理学]