集束化护理结合保温策略在行脊柱后入路术患者围手术期的应用效果OA
Application effect of cluster nursing combined with heat preservation strategy in the perioperative period of patients undergoing posterior spinal approach surgery
目的 考察集束化护理结合保温策略在行脊柱后入路术患者围手术期的应用效果.方法 选取2021年1月至2022年12月在江南大学附属医院行脊柱后入路术治疗的90例患者作为研究对象,并根据干预方式的差异分为观察组和对照组,每组45例.对照组给予常规护理进行干预,观察组给予集束化护理结合保温策略进行干预,比较2组的指标变化.结果 2组在手术开始后90 min的核心体温均低于麻醉开始、手术开始后30 min和60 min,且手术开始后60 min也均低于麻醉开始(P均＜0.05);手术开始后30 min、60 min和90 min,观察组的核心体温均高于同期对照组(P均＜0.05);观察组的气管拔管和完全清醒时间均早于对照组,并发症总发生率低于对照组(P均＜0.05).手术后2 h和6 h,2组的活化部分凝血酶原时间和凝血酶原时间均长于手术前2 h,平均动脉压、心率、纤维蛋白原水平及简化舒适状况量表评分均高于手术前2 h(P均＜0.05),且手术后6 h也均优于手术后2 h(P均＜0.05);手术后2 h和6 h,观察组的以上指标和评分均优于同期对照组(P均＜0.05).结论 集束化护理结合保温策略可稳定行脊柱后入路术患者的术中核心体温,缩短拔管和苏醒时间,缓解生理应激反应,改善凝血功能,提高术后舒适度,并降低并发症发生率.
Objective To investigate the application effect of cluster nursing combined with heat preservation strategy in the perioperative period of patients undergoing posterior spinal approach surgery.Methods Ninety patients who underwent posterior spinal approach surgery at Affiliated Hospital of Jiangnan University from January 2021 to December 2022 were selected as the study subjects,and were divided into an observation group and a control group based on the difference in intervention methods,with 45 cases in each group.The control group received routine nursing intervention,while the observation group received cluster nursing combined with heat preservation strategy intervention.The changes in indicators between the two groups were compared.Results The core body temperature of both groups at 90 minutes after surgery was lower than that at the beginning of anesthesia,30 minutes and 60 minutes after surgery,and the core body temperature at 60 minutes after surgery was also lower than that at the beginning of anesthesia(all P＜0.05).After 30 minutes,60 minutes,and 90 minutes of surgery,the core body temperature of the observation group was higher than that of the control group during the same period(all P＜0.05).The tracheal extubation and complete awakening time in the observation group were earlier than those in the control group,and the total incidence of complications in the observation group was lower than that in the control group(all P＜0.05).At 2 and 6 hours after surgery,the activated partial thromboplastin time and prothrombin time in both groups were longer than those at 2 hours before surgery,and the average arterial pressure,heart rate,fibrinogen level,and simplified General Comfort Questionnaire scores in both groups were all higher than those at 2 hours before surgery(all P＜0.05).The above indicators and scores of both groups were also better at 6 hours after surgery than at 2 hours after surgery(all P＜0.05).At 2 and 6 hours after surgery,the above indicators and scores in the observation group were better than those in the control group during the same period(all P＜0.05).Conclusion Cluster nursing combined with heat preservation strategy can stabilize the intraoperative core body temperature of patients undergoing posterior spinal approach surgery,shorten extubation and recovery time,alleviate physiological stress reactions,improve coagulation function,enhance postoperative comfort,and reduce the incidence of complications.
蒋玲琳;叶蕾;计晓萍
江南大学附属医院,江苏无锡,214000
临床医学
脊柱后入路术集束化护理保温策略核心体温凝血功能
posterior spinal approach surgerycluster nursingheat preservation strategycore body temperaturecoagulation function
《中西医结合护理（中英文）》 2024 (005)
13-16 / 4
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