复合保温策略在肝囊型棘球蚴病患者围手术期的应用效果

doi:10.20047/j.issn1673-7210.2023.11.37

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摘要目的探讨复合保温策略在肝囊型棘球蚴病患者围手术期护理中的应用效果。方法选取2021年1月至12月新疆医科大学第一附属医院肝胆包虫病科行手术治疗的肝囊型棘球蚴病患者77例，按随机数字表法将其分成对照组38例，试验组39例。对照组采用常规保温护理，试验组在对照组基础上实施复合保温策略。观察两组入室时、麻醉前、切皮前及术中30、60、90、120、150、180 min及结束时的体温，比较两组低体温、术后寒战和苏醒期躁动的发生情况，观察两组气管导管拔管时间和麻醉恢复室（PACU）滞留时间，比较两组术前、术后凝血功能的情况。结果两组术中体温在组间、时间和交互作用比较，差异有统计学意义（P＜0.05）。两组入室时、麻醉前及切皮前体温比较，差异无统计学意义（P＞0.05）。试验组术中30、60、90、120、150、180 min及结束时的体温均高于对照组，差异有统计学意义（P＜0.05）。试验组低体温、寒战和苏醒期躁动发生率均低于对照组，差异有统计学意义（P＜0.05）；试验组气管导管拔管时间和PACU滞留时间短于对照组，差异有统计学意义（P＜0.05）；术后，两组血浆凝血酶原时间、凝血酶时间、活化部分凝血酶时间均长于术前，纤维蛋白原低于术前，两组术后凝血四项比较，差异有统计学意义（P＜0.05）。结论复合保温策略能够维持肝囊型棘球蚴病患者术中体温相对稳定，预防低体温、寒战和躁动的发生，促进麻醉苏醒，且有助于患者凝血功能稳定。

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	古丽苏木汗·阿布来提1 木巴拉克·依克拉木1 陈晗2 蒋宇1 赵萍3 王梅新4

关键词 ：肝囊型棘球蚴病, 复合保温策略, 低体温, 麻醉苏醒

Abstract：Objective To explore the effect of compound insulation strategy in perioperative patients with hepatic cystic echinococcosis. Methods A total of 77 patients with hepatic cystic echinococcosis who underwent surgical treatment in the Department of Hepatobiliary Echinococcosis of the First Affiliated Hospital of Xinjiang Medical University in Xinjiang Uygur Autonomous Region from January to December 2021 were selected, they were divided into control group (38 cases) and experimental group (39 cases) according to random number table method. The control group was treated with conventional insulation nursing, and the experimental group was treated with compound insulation strategy. The body temperature of the two groups were observed at the time of entry, before anesthesia, before incision, 30, 60, 90, 120, 150, 180 min and the end during the surgery. The occurrence of hypothermia, postoperative chills and agitation during recovery were compared between the two groups, the extubation time of tracheal catheter and the retention time of postanesthesia care unit (PACU) were observed in the two groups, the coagulation function of the two groups was compared before and after operation. Results Intraoperative body temperature was compared between the two groups in terms of inter-group, time and interaction, and the differences were statistically significant (P＜0.05); there was no significant difference in body temperature between the two groups at the time of entry, before anesthesia, and before skin resection (P＞0.05), the body temperature of experimental group 30, 60, 90, 120, 150, 180 min and the end was higher than that of control group, and the differences were statistically significant (P＜0.05). The incidence of hypothermia, chills, and agitation in experimental group were lower than that in control group, the differences were statistically significant (P＜0.05). Tracheal catheter extubation time and PACU retention time of experimental group were shorter than those of control group, and the differences were statistically significant (P＜0.05). After surgery, prothrombin time, thrombin time and activated partial thromboplastin time were longer than before surgery, but fibrinogen was less than before surgery the two groups, the four items of postoperative coagulation were compared between the two groups, and the differences were statistically significant (P＜0.05). Conclusion The compound insulation strategy can maintain the relative stability of intraoperative body temperature in patients with hepatic cystic echinococcosis, prevent the occurrence of hypothermia, chills, and agitation, promote anesthesia recovery, and contribute to the stability of coagulation function in patients.

Key words： Hepatic cystic echinococcosis Compound insulation strategy Hypothermia Anesthesia recovery

基金资助:新疆维吾尔自治区研究生创新项目（XJ2021G210）。

通讯作者: 王梅新（1958-），女，教授，主任护师；研究方向：临床护理。

作者简介: 古丽苏木汗·阿布来提（1990-），女，新疆医科大学护理学院2019级护理学专业在读硕士研究生，现工作于新疆医科大学第一附属医院；研究方向：临床护理。

引用本文:

古丽苏木汗·阿布来提1 木巴拉克·依克拉木1 陈晗2 蒋宇1 赵萍3 王梅新4. 复合保温策略在肝囊型棘球蚴病患者围手术期的应用效果[J]. 中国医药导报, 2023, 20(11): 162-166.
Gulisumuhan Abulaiti1 Mubalake Yikelamu1 CHEN Han2 JIANG Yu1 ZHAO Ping3 WANG Meixin4. Effect of compound insulation strategy in perioperative patients with hepatic cystic echinococcosis. 中国医药导报, 2023, 20(11): 162-166.

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