基于PDCA循环管理的术中冲洗液加温在骨科手术的应用价值  

Application Value of Intraoperative Irrigating Fluid Heating Based on PDCA Circulation Management in Orthopedic Surgery

作　　者：王萌萌 WANG Meng -meng(Operation Room,the Fourth Central Hospital of Tianjin,Tianjin 300142,China)

机构地区：[1]天津市第四中心医院手术室,天津300142

出　　处：《中国伤残医学》2023年第17期18-21,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨与分析基于PDCA循环管理的术中冲洗液加温在骨科手术的应用价值。方法:选择我院骨科2019年9月-2022年5月进行手术的患者102例作为研究对象,根据1:1随机电脑分配原则把患者分为观察组(PDCA组,51例)与对照组(传统组,51例)。所有患者在围术期都给予术中冲洗液加温管理,对照组给予围术期常规护理,观察组在对照组护理的基础上给予PDCA循环管理护理,观察与记录围术期低体温(Perioperative inadvertent hypothermia,PIH)发生情况。结果:观察组的麻醉苏醒时间、术后住院时间、术后下床活动时间、术后首次排气时间、术后进普食时间与对照组相比都明显减少(P<0.05)。观察组术前10分钟、手术开始后1小时、手术结束后1小时的鼻咽温度对比无明显差异(P>0.05),都处于正常范围内,观察组手术开始后1小时、手术结束后1小时的鼻咽温度高于对照组(P<0.05)。观察组术后3天周期内的低体温发生率为2.0%,与对照组的13.7%相比有明显降低(X^(2)=4.883,P=0.027)。观察组术后7天的感染、静脉血栓、空气栓塞、尿潴留等并发症发生率为3.9%,对照组为17.6%,观察组与对照组相比明显降低(P<0.05)。结论:基于PDCA循环管理的术中冲洗液加温在骨科手术的应用能维持患者的鼻咽温度处于正常范围内,降低围术期低体温发生率,还可降低患者并发症发生率,促进患者康复。Objective:To explore and analysis the application values of intraoperative flushing fluid heating based on PDCA circula-tion management in orthopedic surgery.Methods:From September 2019 to May 2022,102 cases of patients who underwent orthopedic surgery in a certain hospital were selected as the study subjects.According to the principle of 1:1 random computer distribution,the pa-tients were divided into PDCA group(51 cases)and traditional group(51 cases).All patients were given intraoperative flushing fluid heating management,the traditional group was given routine perioperative care,and the PDCA group was given PDCA circulation man-agement nursing on the basis of the traditional groups nursing,and the occurrence of perioperative hypothermia(PIH)was observed and recorded.Results:Compared with the traditional group,the time of awakening from anesthesia,the time of hospitalization after opera-tion,the time of getting out of bed after operation,the time of first exhaust after operation,and the time of getting into general diet after operation in PDCA group were significantly reduced(P<0.05).There was no significant difference in the nasopharynx temperature of the PDCA group 10 min before operation,1 h after operation and 1 h after operation(P>0.05),which were within the normal range.The nasopharynx temperature of the PDCA group 1 h after operation and 1 h after operation was higher than that of the traditional group(P<0.05).The incidence of hypothermia within 3 days after operation in PDCA group was 2.0%,which was significantly lower than 13.7%in traditional group(X^(2)=4.883,P=0.027).The incidence of infection,venous thrombosis,air embolism,urinary retention and other complications 7 days after operation was 3.9%in the PDCA group and 17.6%in the traditional group.Compared with the tra-ditional group,the incidence of complications in the PDCA group was significantly lower(P<0.05).Conclusion:The application of in-traoperative irrigating fluid heating based on PDCA circulation management in orthopedic surgery can maint

关 键 词：PDCA循环管理 术中冲洗液加温 骨科手术 围术期低体温 鼻咽温度 并发症 

分 类 号：R473[医药卫生—护理学]