术中保温结合舒适体位护理对乳腺癌患者术中核心体温及凝血功能的影响  

Effect of intraoperative thermal insulation combined with comfortable postural nursing on core body temperature and coagulation function in patients with breast cancer

作　　者：李笑 严丽洁[1] 张倩[1] LI Xiao;YAN Lijie;ZHANG Qian(Department of Anesthesia Surgery,the First Affiliated Hospital of Nanjing Medical University,Jiangsu Province,Nanjin 210029,China)

机构地区：[1]南京医科大学第一附属医院麻醉手术科,江苏南京210029

出　　处：《中国医药导报》2023年第36期165-168,193,共5页China Medical Herald

基　　金：江苏省研究生科研创新计划项目(SJCX20_0523)。

摘　　要：目的 探究术中保温结合舒适体位护理对乳腺癌患者术中核心体温及凝血功能的影响。方法 以南京医科大学第一附属医院自2020年1月至2022年1月抽取的89例乳腺癌患者作为研究对象,按照随机数字表法将其分为对照组(n=44)和观察组(n=45),对照组采取术中保温+常规体位干预,观察组应用术中保温结合舒适体位护理,比较两组不同时间点体温变化、凝血功能指标变化。结果 整体分析发现:体温组间比较、时间点比较及交互作用差异均有统计学意义(P<0.05)。进一步两两比较,组内比较:观察组插管前体温低于术前,拔管后60 min及手术完成时体温高于插管前,差异有统计学意义(P<0.05),对照组插管前及拔管后60 min体温低于术前,拔管后60 min、手术完成时体温高于插管前,且手术完成时体温高于拔管后60 min,差异有统计学意义(P<0.05)。组间比较:观察组插管前、拔管后60 min体温高于对照组,差异有统计学意义(P<0.05)。术后24 h,两组凝血酶时间、活化部分凝血活酶时间、凝血酶原时间、纤维蛋白原高于术前,但观察组低于对照组;两组血小板计数低于术前,但观察组高于对照组,差异有统计学意义(P<0.05)。结论 针对乳腺癌患者给予术中保温结合舒适体位护理,可有效避免患者术中出现低体温现象,改善其凝血功能指标,利于患者良好预后,值得各个科室借鉴采纳。Objective To explore the effect of intraoperative thermal insulation combined with comfortable postural nursing on core body temperature and coagulation function in patients with breast cancer.Methods A total of 89 breast cancer patients from the First Affiliated Hospital of Nanjing Medical University from January 2020 to January 2022 were selected as the study objects,they were divided into control group(n=44)and observation group(n=45)according to random number table method.The control group was treated with intraoperative thermal insulation+conventional postural intervention,and the observation group was treated with intraoperative thermal insulation combine with comfortable postural nursing,the changes of body temperature and coagulation function indexes were compared between the two groups at different time points.Results Overall analysis showed that there were statistically significant differences in body temperature between groups,time point,and interaction comparison(P<0.05).Further pairwise comparison and intra-group comparison:in the observation group,the body temperature before intubation was lower than before operation,60 min after extubation and after surgery was higher than that before intubation,and the differences were statistically significant(P<0.05).In the control group,the body temperature before intubation and 60 min after extubation was lower than that before operation,and the body temperature 60 min after extubation and after surgery was higher than that before intubation.The body temperature at the completion of the operation was higher than 60 min after extubation,and the differences were statistically significant(P<0.05).Comparison between groups:the body temperature of the observation group before intubation and 60 min after extubation was higher than that of the control group,and the difference was statistically significant(P<0.05).Twenty-four hours after operation,thrombin time,activated partial thrombin time,prothrombin time and fibrinogen in two groups were higher than before operat

关 键 词：术中保温 舒适体位护理 乳腺癌 核心体温 

分 类 号：R473[医药卫生—护理学]