摘要
目的探讨复合保温对老年手术患者术后手术部位感染、炎性因子及复苏期寒战的影响,为老年患者术中术后手术部位感染及低体温的预防提供参考。方法选取2017年6-12月在医院行腹部手术的120例老年患者为研究对象,按照数字表格法随机分为对照组与研究组,每组60例,对照组患者术中给与常规保温,研究组患者术中给予复合保温措施,观察两组患者麻醉时、术中30min、术中60min、术中120min、术中180min、术后30min时患者直肠温度,术前、术后24h、48h时炎症因子降钙素原(PCT)、C-反应蛋白(CRP)、白细胞计数(WBC)变化情况,复苏期寒战及术后手术部位感染发生情况。结果两组患者围手术期不同时点体温组间比较差异有统计学意义(P<0.05),且研究组患者围手术期体温变化优于对照组(P<0.05);两组围术期不同时点PCT、CRP、WBC比较差异有统计学意义(P<0.05);且对照组术后24h和48h炎症因子PCT、CRP、WBC水平均高于研究组(P<0.05);对照组患者复苏期寒战发生率15.00%高于研究组的发生率3.33%(P<0.05),两组患者术后手术部位感染率比较差异无统计学意义。结论老年手术患者术中给与复合保温措施进行保温,有利于维持术中正常体温保持稳定,降低术后复苏期寒战发生率,减轻围术期炎性反应,对术后手术部位感染无明显影响。
OBJECTIVE To explore the influence of compound incubation on postoperative surgical site infection,inflammatory factors and shiver during recovery period in elderly patients so as to provide guidance for prevention of postoperative surgical site infection and hypothermia in the elderly patients.METHODS A total of 120 elderly patients who underwent abdominal surgery in the hospital from Jun 2017 to Dec 2017 were recruited as the study objects and randomly divided into the control group and the study group,with 60 cases in each group.The control group was given intraoperative conventional heat preservation,and the study group was treated with intraoperative compound insulation measures.Rectal temperature was measured at anaesthesia,30 min,60 min,120 min during the surgery as well as 30 min after the surgery;the levels of inflammatory factors procalcitonin,C-reactive protein(CRP)and white blood cells were determined before the surgery and after the surgery for 24 and 48 hours;the incidence of shiver during recovery period and postoperative surgical site infection was observed.RESULTS There was significant difference in the body temperature between the two groups of patients at different time points during the perioperative period(P<0.05),the perioperative body temperature changed more significantly in the study group than in the control group(P<0.05).There were significant differences in PCT,CRP and WBC between the two groups at different time points during the perioperative period(P<0.05).The levels of PCT,CRP and WBC of the control group were significantly higher than those of the study group after the surgery for 24 and 48 hours(P<0.05).The incidence rate of shiver during recovery period of the control group was 15.00%,significantly higher than 3.33%of the study group(P<0.05).There was no significant difference in the incidence of postoperative surgical site infection between the two groups.CONCLUSION The intraoperative compound insulation may facilitate the maintenance of stable body temperature,reduce the incid
作者
费晓青
徐小春
张敏
陈晶晶
魏丽君
FEI Xiao-qing;XU Xiao-chun;ZHANG Min;CHEN Jing-jing;WEI Li-jun(Ningbo Second Hospital,Ningbo,Zhejiang315010,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1433-1437,共5页
Chinese Journal of Nosocomiology
基金
浙江省科技计划基金资助项目(201539801)
关键词
复合保温
老年
手术
手术部位感染
炎性因子
复苏期
寒战
Compound insulation
Elderly
Surgery
Surgical site infection
Inflammatory
Recovery period
Shiver
