關(guān)于小兒圍手術(shù)期低體溫護理要點的探討

論文編號:HL159  論文字數(shù):9915.頁數(shù):22

論文題目：小兒圍手術(shù)期低體溫護理干預
摘　要
 目的：通過對小兒圍手術(shù)期實施一系列低體溫護理干預，評價干預措施的有效性，為臨床護理提供指導作用。
 方法：兩組患者均采用溫度監(jiān)測儀測定患者體溫。全麻開始后將測溫導線探頭插入直腸內(nèi)至手術(shù)結(jié)束，每30min測1次直腸溫度并記錄。（1）對照組患者術(shù)野以外身體蓋雙層大單，用常溫皮膚消毒劑，術(shù)中輸血輸液及沖洗采用常溫液體。（2）干預組患者采用保溫護理干預穿上開放型分段式非手術(shù)部位保溫棉衣，將溫度調(diào)節(jié)至36～40℃，皮膚消毒劑加溫至40℃左右，術(shù)中輸液使用輸液加溫器，沖洗液用恒溫箱加溫至38℃左右。手術(shù)結(jié)束后抽取靜脈血及收集尿液，檢測電解質(zhì)；記錄麻醉蘇醒時間、有無寒戰(zhàn)發(fā)生；并隨訪術(shù)后切口感染率。
 結(jié)果：與干預組比較，對照組圍手術(shù)期MAP、HR、T、變化較大（P＜0.05，P＜0.01）；SaO2、電解質(zhì)、LDH變化不大（P＜0.05）；CK、心律失常和術(shù)后并發(fā)癥明顯增高（P＜0.05）；低溫出現(xiàn)血小板減少、凝血酶原時間延長和術(shù)中滲血增加（P＜0.05）；年齡和體表面積與低溫發(fā)生呈相關(guān)性。
 結(jié)論：小兒圍手術(shù)期易出現(xiàn)低溫，低溫可增加圍手術(shù)期的危險性，術(shù)中及早發(fā)現(xiàn)體溫過低并及時進行護理干預可以有效的防止低體溫并發(fā)癥的發(fā)生，以利患兒的早日康復。

 關(guān)鍵詞：小兒；低溫；圍手術(shù)期；護理干預

 論文類型：應用研究
 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  錄
 1 緒 論
 1.1 背景和意義-------------------------------------------------------------------------------（1）
 1.2 目的及目標-------------------------------------------------------------------------------（1）
 1.3 關(guān)鍵詞及定義----------------------------------------------------------------------------（1）
 1.4 文獻回顧----------------------------------------------------------------------------------（2）
 2 資料與方法
 2.1 研究對象----------------------------------------------------------------------------------（4）
 2.2 研究方法----------------------------------------------------------------------------------（4）
 2.3 觀察指標----------------------------------------------------------------------------------（5）
 2.4 統(tǒng)計學處理-------------------------------------------------------------------------------（5）
 3 結(jié) 果
 3.1 兩組患兒不同時期的肛溫比較-------------------------------------------------------（5）
 3.2 兩組臨床觀察指標及并發(fā)癥的比較-------------------------------------------------（5）
 3.3 兩組實驗室指標的變化----------------------------------------------------------------（6）
 3.4 兩組住院天數(shù)與總費用的比較-------------------------------------------------------（8）
 4.討 論
 4.1 小兒圍手術(shù)期低體溫的發(fā)生機制----------------------------------------------------（9）
 4.2 小兒圍手術(shù)期低體溫的危害----------------------------------------------------------（10）
 4.3 小兒圍手術(shù)期的護理干預------------------------------------------------------------（11）
 5 結(jié) 論-----------------------------------------------------------------------------------------（13）
 參考文獻----------------------------------------------------------------------------------------（14）
 致 謝-------------------------------------------------------------------------------------------（15）