Abstract：Objective To explore the application effect of operating room nursing based on compound insulation intervention in temperature control of cesarean delivery. Methods A total of 105 cases of women undergoing cesarean section in Xuancheng Central Hospital, Anhui Province from June 2019 to May 2021 were selected as the research subjects, and they were divided into control group 52 cases and experimental group 53 cases by random number table method. Routine thermal insulation intervention was used in the control group and compound thermal insulation intervention was used in the experimental group. Temperature change, incidence of hypothermia and chills, and thermal comfort score were compared between the two groups during childbirth and obstetrics. The changes of coagulation indexes before and after operation were compared between the two groups. Results Tympanic membrane temperature was different at different time and group, and there was an interaction between time and group (P ＜ 0.05). Comparison within the group showed that the temperature of maternal tympanic membrane in the control group was lower than that in the same group to the operating room (T0) at the time of skin incision (T2), fetal delivery (T3), fetal delivery 10 min (T4), fetal delivery 20 min (T5), fetal delivery 30 min (T6), and the end of operation (T7) (P ＜ 0.05). At T4 - T7, the temperature of maternal tympanic membrane in test group was lower than that at T0 (P ＜ 0.05). At (T1), T2 - T7, the temperature of the tympanic membrane in experimental group were higher than that in control group (P ＜ 0.05). The rates of hypothermia and chills in the experimental group were lower than those in the control group (P ＜ 0.05). Postpartum thermal comfort score of experimental group was lower than that of control group (P ＜ 0.05). The values of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) in the control group were higher than those before operation (P ＜ 0.05), while fibrinogen (FIB) was lower than that before operation (P ＜ 0.05). The values of PT, APTT, and TT in experimental group were lower than those in control group (P ＜ 0.05), and FIB value was higher than that in control group (P ＜ 0.05). Conclusion Operating room nursing based on compound insulation intervention can help maintain the relative stability of maternal body temperature, reduce the incidence of hypothermia and chills, enhance maternal thermal comfort, and also have a certain protective effect on coagulation function.
[1] Thorburn PT，Monteiro R，Chakladar A，et al. Maternal temperature in emergency caesarean section （MATES）：an observational multicentre study [J]. Int J Obstet Anesth，2021，46：102963.
[2] 刘媛，徐宏涛，胡英，等.手术室积极保暖干预措施对剖宫产术手手术源性低体温的影响[J].中国医院统计，2018， 25（5）：376-380.
[3] 刘婷婷，欧阳玲.围术期实施复合保温对卵巢恶性肿瘤患者术后康复的影响[J].中国医科大学学报，2020，49（11）：1042-1045.
[4] Wrench IJ，Gavill G，Ward JE，et al. Comparison between alfentanil，pethidine and placebo in the treatment of post-anaesthetic shivering [J]. Br J Anaesth，1997，79（4）：541-542.
[5] 梁海燕.多模式保温对产妇在剖宫产术中体温的应用[J].现代医药卫生，2017，33（6）：892-893.
[6] Qiao J，Wang YY，Li XH，et al. A Lancet Commission on 70 years of women’s reproductive，materanl，newbron，child，and adluescent health in China [J]. Lancet，2021， 397（10293）：2497-2536.
[7] 孔珊珊，邓露，申海艳，等.剖宫产产妇术中低体温风险预测模型的构建及应用效果研究[J].中华护理杂志，2021， 56（2）：165-171.
[8] 李迎春，段燕，杨利，等.不同保温措施对剖宫产产妇术中低体温预防效果的系统评价[J].循证护理，2018，4（6）：488-495.
[9] Kishore N，Payal YS，Kumar N，et al. In Spinal Anaesthesia for Cesarean Section the Temperature of Bupivacaine Affects the Onset of Shivering but Not the Incidence：A Randomized Control Trial [J]. J Clin Diagn Res，2016，10（1）：UC18-21.
[10] 赵梦茜.瘢痕子宫合并前置胎盘产妇剖宫产术中低体温的影响因素分析[J].中国妇幼保健，2020，35（22）：4221-4223.
[11] Mullington CJ，Low DA，Strutton PH，et al. Body temperature，cutaneous heat loss and skin blood flow during epidural anaesthesia for emergency caesarean section [J]. Anaesthesia，2018，73（12）：1500-1506.
[12] 谭静.围手术期连袖披肩保暖对预防剖宫产孕产妇术中低体温寒战发生的效果分析[J].中国实用乡村医生杂志，2018，25（7）：56-58.
[13] 聂鑫，丁杰，孙彩凤.稀释式和回收式自体血回输在凶险性前置胎盘剖宫产中止血效果及对母婴结局影响[J].中国医药导报，2020，17（32）：79-82，99.
[14] Tsen LC. Too cold，too hot or just right? Temperature regulation during caesarean section [J]. Anaesthesia，2019，74（8）：973-975.
[15] 杨敏毅.围手术期综合保温干预在剖宫产患者中的应用研究[J].上海护理，2021，21（2）：42-44.
[16] 许立倩，曹艳冰，戴红霞，等.充气式保温毯用于麻醉复苏室全麻恢复期患者中的效果观察[J].护理学杂志，2019， 34（14）：31-32.
[17] 廖佳瑜，唐爱君.“暖宝宝”预防冬春季外周留置针堵管的效果观察[J].基层医学论坛，2017，21（32）：4567-4568.
[18] 朱俊，张月娟，谌永毅，等.暖宝宝中药贴敷神阙穴、足三里对剖宫产后肠胀气的效果观察[J].中国医学创新，2017，14（4）：91-94.
[19] AORN Recommended Practices Committee. Recommended practices for thd prevention of unplanned perioperative hypothermia [J]. ARON J，2007，85（5）：972-988.
[20] Butwick AJ，Lipman SS，Carvalho B. Intraoperative forced air-warming during cesarean delivery under spinal anesthesia does prevent maternal hypothermia [J]. Anesth Analg，2007，105（5）：1413-1419.
[21] 徐秀群，张佳佳，朱琴，等.体温保护在围术期患者中的应用现状及研究进展[J].东南大学学报（医学版），2020， 39（2）：229-232.
[22] 刘洪敏.情绪安抚联合液体保温整体护理策略对高龄剖宫产的应用效果[J].河南医学研究，2020，29（27）：5168-5170.
[23] 尚勇，李帆，胡振飞，等.硫酸镁预防剖宫产术产妇寒战的meta分析[J].中国医药导报，2020，17（21）：103-108.
[24] 张玉杰，杨宇.老年患者前列腺电切手术期间体温保护的临床观察[J].第三军医大学学报，2016，38（18）：2096-2099.
[25] 李渊，马玉姗.格拉司琼剂量对于改善腰麻剖宫产术产妇低血压作用的研究[J].中华妇幼临床医学杂志（电子版），2019，15（1）：51-56.
[26] 张士民，吴华彬.不同浓度罗哌卡因硬膜外分娩镇痛对产妇鼓膜温度白细胞介素-6分娩结局的影响[J].中国药物与临床，2021，21（6）：941-943.
[27] 袁敏，万素莲，费蕾蕾.音乐放松联合保暖贴减少产妇剖宫产术中低体温、应激反应、寒战的效果观察[J].中华现代护理杂志，2018，24（3）：320-323.
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