摘要
目的 探讨实施复合保温护理的冠心病搭桥手术患者的保温效果.方法 回顾性选择锦州市中心医院2012年1月至2015年1月冠心病搭桥手术病例160例,其中保温组80例患者采用复合保温护理措施,常规组80例患者为常规护理.为避免手术操作差异性对患者术后并发症的影响,全部病例为同一术者及手术团队完成.两组患者在年龄、性别、病史、手术过程等方面未见统计学差异.对两组患者的中心温度实施多个时间点监测,同时观察、记录术后并发症情况.通过加强患者转运过程、消毒过程、手术操作过程及术后的护理,达到保温的目的.结果 两组患者体外循环结束时中心温度均恢复至36℃～37 ℃.出室时保温组温度下降不显著,最低降至（35.9±1.8）℃,而常规组已经出现明显下降,最低降至（34.7±1.5）℃,差异有统计学意义（P＜0.05）.常规组术后5h引流量增加83.9％,凝血酶原时间延长102.1％,机械通气时间延长96.8％,心血管不良事件发生率增加68.2％,与保温组相比均存在很大差异,而常规护理组患者在ICU滞留的时间仅延长3.9％,未见统计学差异.结论 单一的保温措施往往收效甚微.本研究中保温组采取了复合保温措施后,患者体温的变化幅度、各种并发症发生率、住院治疗的时间和费用均优于常规护理组,收到了满意的效果.
Objective To investigate the effects of heat preservation in patients undergoing coronary artery bypass grafting with composite insulation. Methods 160 cases of coronary artery bypass surgery in our hos- pital from January 2015 to January 2012 were retrospectively reviewed. 80 patients with heat preservation group were treated with composite heat preservation and 80 patients were treated by routine nursing. In order to avoid the influence of the difference of operation on postoperative complications, all cases were completed by the same sur- geon and surgical team. The differences in age, gender, medical history, operation process and so on in the two groups were not statistically significant. In the heat preservation group, the nursing measure of composite heat preservation was carried out. The central temperature of the two groups was monitored, and the postoperative com- plications were observed and recorded. The purpose of holding the heat preservation was to strengthen the nursing of the patients during the course of the transfer, and the operation of the operation and the nursing. Results The central temperature of the two groups were restored to 36℃-37 ℃ at the end of the cardiopulmonary bypass, and the temperature of the heat preservation group was not significantly decreased, lowest to （35.9±1.8）℃, while the conventional group was significantly decreased, the difference was statistically significant lowest to （34.7±1.5）℃ （P〈0.05）. There were significant differences in the two hours after operation, the time of thrombin, the time of mechanical ventilation and the incidence of adverse cardiovascular events in the 5 groups, but there were no significant differences in the time between the two groups in ICU. Conclusion Single thermal insulation measures often have little effect, in the study of the heat preservation group to take composite insulation measures, the patient＇ s body temperature changes, the incidence of complications, hospitalization time and cost are better than the conventional nursing group, received satisfactory results.
出处
《中国心血管病研究》
CAS
2016年第6期572-574,共3页
Chinese Journal of Cardiovascular Research
关键词
低体温
保温护理
冠心病搭桥术
围术期
Low temperature
Heat preservation nursing
Coronary artery bypass grafting
Perioper ative period
