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Effects of perioperative period thermal insulation intervention on stress response and complications in patients undergoing thoracoscopic lung surgery under general anesthesia |
WANG Yan YAN Li ZHANG Jianmei ZHONG Zhaoping |
Department of Surgery Anesthesiology, Huaian First People’s Hospital, Jiangsu Province, Huaian 223300, China |
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Abstract Objective To investigate the effects of perioperative period thermal insulation intervention on stress response and complications in patients undergoing thoracoscopic lung surgery under general anesthesia. Methods A total of 110 patients with thoracoscopic lung surgery treated in Huaian First People’s Hospital, Jiangsu Province from October 2019 to November 2022 were selected as the study objects, and they were divided into control group (55 cases) and observation group (55 cases) by random number table method. The control group received routine intervention in perioperative period, and the observation group received thermal insulation intervention in perioperative period on the basis of control group. Both groups were observed until the patients left the anesthesia recovery room. The body temperature between two groups was compared before anesthesia (T0), 60 min after the operation (T1), at the end of operation (T2), immediately after entering the anesthesia recovery room (T3), 15 min after entering the anesthesia recovery room (T4), and at the exit of the anesthesia recovery room (T5); the levels of norepinephrine (NE), epinephrine (E), and cortisol (Cor) at T0, T2, and T4 were compared between two groups; the occurrence of complications in two groups was observed. Results Overall comparison: there were statistically significant differences in body temperature time, inter-group, and interaction between two groups (P<0.05). Intra-group comparison: compared with T0, the body temperature of control group decreased at T1; compared with T1, the body temperature was increased at T2-T5, and the differences were statistically significant (P<0.05). Compared with T0, the body temperature of observation group was increased at T2-T5, and the differences were statistically significant (P<0.05). Comparison between groups: the body temperature of observation group at T1-T5 was higher than that of control group, and the difference was statistically significant (P<0.05). Overall comparison: there were statistically significant differences in the levels of NE, E, and Cor time, inter-group, and interaction between two groups (P<0.05). Intra-group comparison: the pairwise comparison of the levels of NE, E, and Cor in two groups at different time points had statistical significance (P<0.05). Comparison between groups: the levels of NE, E and Cor at T2, T4 in observation group were lower than those in control group, and the differences were statistically significant (P<0.05). The total incidence of complications in observation group was lower than that in control group, and the difference was statistically significant (P<0.05). Conclusion Perioperative thermal insulation intervention could help maintain the body temperature of patients undergoing thoracoscopic lung surgery, reduce the stress response, postoperative complications of patients, and had a good intervention effect.
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[1] 张秋实,刘欢,马垚.不同麻醉方式对胸腔镜肺癌根治术患者细胞因子及疼痛的影响[J].癌症进展,2019,17(23):2789-2792. [2] 陈罡,刘秋丽,徐文青,等.胸腔镜肺叶手术患者苏醒室低体温现况及影响因素[J].护理学杂志,2022,37(10):42-45. [3] 曹娜芬,王郑,俞南南.麻醉苏醒护理对胸腔镜肺癌根治术患者术后疼痛程度、躁动、低体温的影响[J].中国医刊,2020,55(3):343-346. [4] 张海艳.基于根本原因分析法的护理措施对胸腔镜非小细胞肺癌手术并发症的影响[J].中国数字医学,2019,14(4):73-75. [5] 王福玲.世界医学会《赫尔辛基宣言》——涉及人类受试者的医学研究的伦理原则[J].中国医学伦理学,2016,29(3):544-546. [6] 陈鸿义.现代胸腔镜外科学[M].北京:人民卫生出版社,1997:40-42. [7] 肉孜姑丽·艾克木,邢娟,盖宁,等.PDCA循环管理模式结合针对性护理干预在完全胸腔镜下心脏手术围术期的应用效果评价[J].新疆医科大学学报,2021,44(7):860-864. [8] 李蕾,刘红丽,党忠萍.综合护理干预对胸腔镜肺癌根治术患者术中护理效果、相关时间指标及心理状态分析[J].贵州医药,2022,46(4):651-652. [9] 陈鹏,吕光,赵宇浩,等.麻醉诱导前给予依达拉奉与地塞米松联合BIS监测对胸腔镜下肺叶切除术后肺保护与术后恢复的影响[J].现代生物医学进展,2023,23(6):1085-1090. [10] 戚钰,周海,王龙,等.麻醉诱导维持阶段复合应用中/小剂量艾司氯胺酮的胸腔镜肺切除术患者术后镇痛效果观察[J].山东医药,2023,63(5):55-58. [11] 朱晓娜,施克俭,潘霖敏.区域麻醉联合镇痛与静脉自控镇痛用于胸腔镜肺手术患者术后镇痛效果的比较[J].中国现代医生,2020,58(22):131-134. [12] 谢影梅,陈君,胡进刚,等.术前强化信息支持联合PMRT护理干预在胸腔镜下肺切除术病人中的应用效果[J].蚌埠医学院学报,2022,47(9):1298-1301. [13] 桑莹莹,方丽梅,夏超,等.快速康复护理路径在胸腔镜肺叶切除术患者中的应用价值[J].实用医学杂志,2019, 35(10):1673-1676. [14] 王静云,宋妙,张彬,等.无缝衔接整体护理对宫颈癌腹腔镜手术患者术中低体温的影响[J].中国医药导报,2023, 20(13):180-183. [15] 刘金华,王平,刘月.基于放松训练的心理护理对胸腔镜非小细胞肺癌手术患者疼痛的影响[J].河北医药,2019,41(4):633-636. [16] 张莉,赵晨.综合保温护理预防胸腔镜肺叶切除手术患者低体温效果观察[J].中国现代医生,2019,57(28):154-156. [17] 吴艳,张冬梅,王秀娟,等.Caprini血栓风险评估模型联合分级护理干预对胸腔镜肺癌切除术后患者静脉血栓形成的影响[J].临床与病理杂志,2022,42(10):2529- 2535. [18] 王亚伟,郁玲.序贯式心理护理联合呼吸专项训练对胸腔镜肺癌手术患者呼吸功能及心理状态的影响[J].川北医学院学报,2021,36(6):802-804. [19] 施庆彤,刁亚利,钱军.单孔胸腔镜手术联合ERAS理念指导下的呼吸功能锻炼在肺癌围手术期的应用[J].中国肺癌杂志,2020,23(8):667-672. [20] 贾佳,楚晓飞,孙爱英,等.单向式完全胸腔镜下肺癌根治术后患者肺部并发症的影响因素及针对性护理干预的效果[J].成都医学院学报,2021,16(5):640-644. [21] 付丽,尚大鹏.呼吸训练疗法对胸腔镜肺大疱切除术后患者生活质量和呼吸功能的影响[J].中国医刊,2020, 55(4):375-378. [22] 韩晓霞,冯光强,孙晓丽,等.快速康复外科对肺结核病胸腔镜肺叶切除术患者临床康复的效果分析[J].中国地方病防治杂志,2020,35(1):84-85. [23] 刘海荣,李方,王蕾.个性化护理结合饮食指导对老年胸腔镜食管癌根治术患者炎性因子的影响[J].长春中医药大学学报,2021,37(4):871-873. [24] 余晓娟.多学科疼痛管理模式在胸腔镜肺叶切除患者中的应用[J].医学理论与实践,2022,35(20):3552-3554. [25] 杨剑,陈杰,黄培雯,等.导航护士主导的三级质控在胸腔镜肺癌切除术患者加速康复中的应用[J].护理学杂志,2022,37(16):12-15. [26] 林雄坡,刘云肖,马京华,等.基于专家共识围手术期预防术中低体温护理措施实施现状[J].中国医药科学,2023,13(3):158-161,165. [27] 张仙金,林昆.术中综合保温护理对剖宫产手术患者术中低体温和术后并发症的影响探究[J].中外医学研究,2021,19(21):95-97. [28] 唐桂香,黄敏锐,伦楚意,等.麻醉诱导期不同保温措施对胃肠开腹手术老年患者围手术期体温的影响[J].中国当代医药,2022,29(15):194-196. |
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