关于小儿围手术期低体温护理要点的探讨

论文编号:HL159  论文字数:9915.页数:22

论文题目：小儿围手术期低体温护理干预
摘　要
 目的：通过对小儿围手术期实施一系列低体温护理干预，评价干预措施的有效性，为临床护理提供指导作用。
 方法：两组患者均采用温度监测仪测定患者体温。全麻开始后将测温导线探头插入直肠内至手术结束，每30min测1次直肠温度并记录。（1）对照组患者术野以外身体盖双层大单，用常温皮肤消毒剂，术中输血输液及冲洗采用常温液体。（2）干预组患者采用保温护理干预穿上开放型分段式非手术部位保温棉衣，将温度调节至36～40℃，皮肤消毒剂加温至40℃左右，术中输液使用输液加温器，冲洗液用恒温箱加温至38℃左右。手术结束后抽取静脉血及收集尿液，检测电解质；记录麻醉苏醒时间、有无寒战发生；并随访术后切口感染率。
 结果：与干预组比较，对照组围手术期MAP、HR、T、变化较大（P＜0.05，P＜0.01）；SaO2、电解质、LDH变化不大（P＜0.05）；CK、心律失常和术后并发症明显增高（P＜0.05）；低温出现血小板减少、凝血酶原时间延长和术中渗血增加（P＜0.05）；年龄和体表面积与低温发生呈相关性。
 结论：小儿围手术期易出现低温，低温可增加围手术期的危险性，术中及早发现体温过低并及时进行护理干预可以有效的防止低体温并发症的发生，以利患儿的早日康复。

 关键词：小儿；低温；围手术期；护理干预

 论文类型：应用研究
 Title:Perioperative Hypothermia pediatric nursing intervention
ABSTRACT
 Objectives: Through the pediatric perioperative nursing intervention inimplement in gaserieso flowbody temperature to evaluate the effective nessof interventions,in order to provide guidance on the role of clinical care.
 Methods: Two groups of patients were used to measure the temperature monitoring in patients with body temperature.Conductor temperature after an esthesia began to probe into the rectum to the end of surgery,each measuring a sub-30min rectal temperature and recorded.（1）control group covered the body outside the surgical field in patients wth large single-layer,with normal temperature of skind is infectants,blood transfusion and washed with room     temperature liquid.（2）The intervention group were treated with thermal insulation of nursing intervention to put an open sub-type of non-surgical site insulation cotton-padded clothes,the temperature adjusted to 36~40℃,the skind is infectant heated to 40℃ or so,the use of intraoperative fluid infusion warming device,flushing fluid with the incubator heated to about 38℃.After the surgery to collect blood and urine to detect electrolyte;record of recovery from anesthesia time,whether shivering occurred;and follow-up postoperative incision infection rate.
 Results: Compared with the constant temperature,low-temperature group of perioperative MAP,HR,T,changed greatly (P<0.05 P<0.01);SaO2,electrolytes,LDH little change     (P>0.05);CK,arrhythmia and postoperative complications were significantly higher (P<0.05);low temperature appears thrombocytopenia,prolonged prothrombin and intraoperative bleeding increased (P<0.05);age and body surface area was associated with the low-temperature occurrence.
 Conclusion: Easy to occur in children of perioperative low temperature,and it can increase the risk of perioperative,intraoperative hypothermia in the early detection and timely nursing intervention can effectively prevent the occurrence of complications of hypothermia to facilitate children''''s early recovery.
 
 Keywords: Children; lowtemperature; perioperative period; nursing intervention
 
 Dissertationcatergory:Application

 
目  录
 1 绪 论
 1.1 背景和意义-------------------------------------------------------------------------------（1）
 1.2 目的及目标-------------------------------------------------------------------------------（1）
 1.3 关键词及定义----------------------------------------------------------------------------（1）
 1.4 文献回顾----------------------------------------------------------------------------------（2）
 2 资料与方法
 2.1 研究对象----------------------------------------------------------------------------------（4）
 2.2 研究方法----------------------------------------------------------------------------------（4）
 2.3 观察指标----------------------------------------------------------------------------------（5）
 2.4 统计学处理-------------------------------------------------------------------------------（5）
 3 结 果
 3.1 两组患儿不同时期的肛温比较-------------------------------------------------------（5）
 3.2 两组临床观察指标及并发症的比较-------------------------------------------------（5）
 3.3 两组实验室指标的变化----------------------------------------------------------------（6）
 3.4 两组住院天数与总费用的比较-------------------------------------------------------（8）
 4.讨 论
 4.1 小儿围手术期低体温的发生机制----------------------------------------------------（9）
 4.2 小儿围手术期低体温的危害----------------------------------------------------------（10）
 4.3 小儿围手术期的护理干预------------------------------------------------------------（11）
 5 结 论-----------------------------------------------------------------------------------------（13）
 参考文献----------------------------------------------------------------------------------------（14）
 致 谢-------------------------------------------------------------------------------------------（15）