本文關(guān)鍵詞：不同保溫措施對(duì)經(jīng)尿道前列腺電切術(shù)患者寒戰(zhàn)的影響研究　出處：《南華大學(xué)》2015年碩士論文　論文類(lèi)型：學(xué)位論文

  更多相關(guān)文章： 前列腺電切 寒戰(zhàn) 低溫 沖洗液 充氣式加溫系統(tǒng)

【摘要】：目的:為探討最佳的物理保溫措施,我們對(duì)TURP患者分別采取了沖洗液加溫、充氣式溫毯機(jī)加溫、沖洗液和溫毯機(jī)聯(lián)合加溫3種保溫方案。觀(guān)察并比較3組患者的體溫和寒戰(zhàn)發(fā)生情況,同步監(jiān)測(cè)生命體征的變化,記錄寒戰(zhàn)、嘔吐、肌肉酸痛等不良反應(yīng)的發(fā)生率,評(píng)價(jià)心肌的氧耗狀況。方法:選擇90例于腰硬聯(lián)合麻醉(CSEA)下?lián)衿谛蠺URP的患者,ASAⅠ~Ⅱ級(jí),年齡50~70歲。采用隨機(jī)數(shù)字表法隨機(jī)地分為3組:A組(沖洗液加溫組)、B組(充氣式溫毯機(jī)加溫組)、C組(沖洗液和溫毯機(jī)聯(lián)合加溫組)。A組將等滲沖洗液放置于可調(diào)控恒溫水箱中保溫,設(shè)定溫度為35℃~37℃,患者上半身覆蓋手術(shù)室常用的普通棉被;B組患者上半身覆蓋充氣式升溫毯,沖洗液為術(shù)前60 min擺放于手術(shù)室內(nèi)的等滲沖洗液;C組沖洗液為預(yù)置于35℃~37℃恒溫水箱的等滲沖洗液,同時(shí)上半身覆蓋充氣式升溫毯。術(shù)中記錄各組患者在病房(T1)、進(jìn)手術(shù)室(T2)、CSEA后5 min(T3)、CSEA后10 min(T4)、持續(xù)沖洗10 min(T5)、持續(xù)沖洗30 min(T6)、持續(xù)沖洗60 min(T7)、持續(xù)沖洗90 min(T8)、停止沖洗(T9)、手術(shù)結(jié)束(T10)各時(shí)間點(diǎn)的腋溫和鼻咽溫情況;觀(guān)察各組寒戰(zhàn)發(fā)生率,并評(píng)估寒戰(zhàn)嚴(yán)重程度;記錄各組嘔吐、肌肉酸痛等不良反應(yīng)的發(fā)生率;同步監(jiān)測(cè)各時(shí)間點(diǎn)HR、MAP、SPO2和心肌耗氧量的變化情況。結(jié)果:1.三種保溫措施對(duì)TURP患者體溫、寒戰(zhàn)發(fā)生情況的影響:各組鼻咽溫的比較差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。A組的鼻咽溫在各時(shí)間點(diǎn)與C組相比均具有統(tǒng)計(jì)學(xué)差異(P0.05),而在某些時(shí)間點(diǎn)與B組比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);寒戰(zhàn)發(fā)生率,A組最高,與B組和C組比較均具有統(tǒng)計(jì)學(xué)差異(P0.05);寒戰(zhàn)分級(jí),A組嚴(yán)重程度均高于其他兩組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。2.三種保溫措施對(duì)主要生命體征的影響:在麻醉前及麻醉后到離開(kāi)手術(shù)室,HR、MAP與SPO2的波動(dòng)幅度,C組均小于A(yíng)組和B組,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.三種保溫措施對(duì)嘔吐、肌肉酸痛等不良反應(yīng)發(fā)生的影響:嘔吐發(fā)生情況,3組比較差異具有統(tǒng)計(jì)學(xué)意義(P0.05),B組和C組比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05);肌肉酸痛發(fā)生情況,A組與B組比較無(wú)統(tǒng)計(jì)學(xué)差異(P0.05),A組、B組肌肉酸痛人數(shù)均多于C組,與C組比較,差異具有統(tǒng)計(jì)學(xué)意義(P0.05)。4.三種保溫措施對(duì)心肌耗氧量的影響:與術(shù)前比較,各組心肌耗氧量均升高(P0.05);其中,A組與B組比較,A組升高明顯(P0.05);C組與B組比較,B組升高明顯(P0.05)。結(jié)論:沖洗液加溫與充氣式溫毯機(jī)加溫相比,預(yù)防低體溫與寒戰(zhàn)的效果無(wú)明顯差異;聯(lián)合應(yīng)用沖洗液加溫與充氣式溫毯機(jī)加溫對(duì)于降低TURP患者術(shù)中寒戰(zhàn)與低體溫的發(fā)生、減輕患者的不適、降低心肌耗氧量等方面具有良好的效果,值得在臨床上推廣。
[Abstract]:Objective: in order to explore the best physical insulation measures, we took the washing solution heating and the inflatable blanket machine to the patients with TURP. The temperature and shivering of the three groups were observed and compared, the changes of vital signs were monitored synchronously, shivering and vomiting were recorded. Incidence of adverse reactions such as muscle soreness, and evaluation of myocardial oxygen consumption. Methods: 90 patients undergoing selective TURP under combined spinal-epidural anesthesia were enrolled in this study. The age was 50 to 70 years old. The patients were randomly divided into three groups: group A (group B), group B (group B), and group B (group B). Group C (washing fluid and warm blanket machine combined with heating group). Group A placed isosmotic flushing fluid in adjustable and constant temperature water tank for heat preservation, setting temperature of 35 鈩，

本文編號(hào)：1362355