围术期复合保温护理对早产儿中心体温的影响(1)
[摘要] 目的 通過不同保温方式对围术期早产儿进行护理，探讨早产儿围术期最佳保温护理方法。 方法 选择2013年1月～2016年6月在丽水市中心医院小儿外科手术的早产儿40例，将采用保温箱转送、术中软棉布包裹、恒温水毯保温，统一用加温的消毒液与输注液体等复合护理措施护理设为观察组，将通过室温调节和液体加温为主的标准化保温护理设为对照组，每组20例。用麻醉手术监测系统记录患儿入手术室即刻(T1)、麻醉后15 min(T2)、30 min(T3)、60 min(T4)、手术结束时(T5)早产儿的中心体温(T)、心率(HR)、血氧饱和度(SpO2)、呼气末二氧化碳(PETCO2)、麻醉深度(BIS)以及术后不良反应等，进行比较分析。 结果 两组体重、手术总时间、输液量等资料，不同时点的SpO2、PETCO2监测结果以及入室时中心体温情况比较差异无统计学意义(P>0.05)。对照组自T4时间点后中心体温较T1时点下降，并在T5时点下降到最低，T4、T5时间点两组中心体温比较差异有统计学意义(P<0.05)。对照组的HR在T4、T5时间点与观察组比较显著增快，且BIS值未因手术结束停用麻醉药而发生改变；而观察组BIS值随着手术结束逐渐增高，观察组在T4、T5的HR、BIS值与对照组比较差异有统计学意义(P<0.05)。 结论 围术期复合保温护理措施能有效维持早产生儿术中体温恒定，预防术中低体温发生，减少不良反应，利于快速康复。
[关键词] 围术期；早产儿；低体温；保温；护理
[中图分类号] R473.72；R722.1 [文献标识码] B [文章编号] 1673-9701(2016)34-0145-05
The effect of perioperative compound nursing of body temperature on central body temperature of premature infants
YANG Bihong1 GAO Lijuan2 WANG Chuanguang3 WANG Shangli1 XIANG Chongwu2 LEI Lipei3 WU Wei3
1.Operation Room， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China； 2.NICU， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China； 3.Department of Anesthesiology， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China
[Abstract] Objective To perform the nursing for perioperative premature infants by different methods of body temperature preservation， and to discuss the optimal nursing methods of body temperature for perioperative premature infants. Methods 40 cases of premature infants who were given pediatric surgery in Lishui Central Hospital from January 2013 to June 2016 were selected. They were divided into two groups. The observation group was given the body temperature preservation by incubator transfer， intraoperative soft cotton wrapping， and constant temperature water blanket， and were given compound nursing measures of heated disinfectant and infusion of liquid； the control group was given standardized nursing of body temperature， which was mainly composed of room temperature regulation and liquid heating. 20 patients were assigned in each group. The central body temperature(T)， heart rate(HR)， oxygen saturation(SpO2)， PETCO2， depth of anesthesia(BIS) and postoperative adverse reactions at the very time point of entering the operation room (T1)， 15 min (T2)， 30 min (T3)， 60 min (T4) after anesthesia， and at the end of operation (T5) were recorded by anesthesia monitoring system， and they were compared and analyzed. Results There were no significant differences between the observation group and the control group in the body height， body weight， total operation time， infusion volume， the monitoring results of SpO2 and PETCO2 at different time points and the central body temperature at the time of entering operation room(P>0.05). In the control group， the central body temperature was decreased from T1 to T4 and decreased to the lowest at T5. There were significant differences between the observation group and the control group at the time points of T4 and T5(P<0.05). HR in the control group at the T4， T5 time points was significantly faster compared with the observation group， and the BIS value was not changed due to discontinuation of anesthesia after the end of surgery； the BIS value in the observation group was gradually increased at the end of surgery. The difference of HR and BIS values at T4 and T5 between the observation group and the control group was statistically significant(P<0.05). Conclusion Perioperative compound nursing of body temperature can effectively maintain the constant body temperature in premature infants， prevent hypothermia during operation and reduce adverse reactions， which is beneficial to rapid rehabilitation. (杨碧虹 高丽娟 王传光)
[关键词] 围术期；早产儿；低体温；保温；护理
[中图分类号] R473.72；R722.1 [文献标识码] B [文章编号] 1673-9701(2016)34-0145-05
The effect of perioperative compound nursing of body temperature on central body temperature of premature infants
YANG Bihong1 GAO Lijuan2 WANG Chuanguang3 WANG Shangli1 XIANG Chongwu2 LEI Lipei3 WU Wei3
1.Operation Room， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China； 2.NICU， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China； 3.Department of Anesthesiology， Lishui Central Hospital in Zhejiang Province， Lishui 323000， China
[Abstract] Objective To perform the nursing for perioperative premature infants by different methods of body temperature preservation， and to discuss the optimal nursing methods of body temperature for perioperative premature infants. Methods 40 cases of premature infants who were given pediatric surgery in Lishui Central Hospital from January 2013 to June 2016 were selected. They were divided into two groups. The observation group was given the body temperature preservation by incubator transfer， intraoperative soft cotton wrapping， and constant temperature water blanket， and were given compound nursing measures of heated disinfectant and infusion of liquid； the control group was given standardized nursing of body temperature， which was mainly composed of room temperature regulation and liquid heating. 20 patients were assigned in each group. The central body temperature(T)， heart rate(HR)， oxygen saturation(SpO2)， PETCO2， depth of anesthesia(BIS) and postoperative adverse reactions at the very time point of entering the operation room (T1)， 15 min (T2)， 30 min (T3)， 60 min (T4) after anesthesia， and at the end of operation (T5) were recorded by anesthesia monitoring system， and they were compared and analyzed. Results There were no significant differences between the observation group and the control group in the body height， body weight， total operation time， infusion volume， the monitoring results of SpO2 and PETCO2 at different time points and the central body temperature at the time of entering operation room(P>0.05). In the control group， the central body temperature was decreased from T1 to T4 and decreased to the lowest at T5. There were significant differences between the observation group and the control group at the time points of T4 and T5(P<0.05). HR in the control group at the T4， T5 time points was significantly faster compared with the observation group， and the BIS value was not changed due to discontinuation of anesthesia after the end of surgery； the BIS value in the observation group was gradually increased at the end of surgery. The difference of HR and BIS values at T4 and T5 between the observation group and the control group was statistically significant(P<0.05). Conclusion Perioperative compound nursing of body temperature can effectively maintain the constant body temperature in premature infants， prevent hypothermia during operation and reduce adverse reactions， which is beneficial to rapid rehabilitation. (杨碧虹 高丽娟 王传光)