摘要目的 探讨全麻苏醒期保温护理对胸腔镜肺手术患者麻醉及应激状况的影响.方法选取2017年1月至2018年7月于四川省宜宾市第二人民医院行全身麻醉手术治疗的120例胸腔镜肺手术患者作为研究对象,按照随机数字表法将其分为对照组与观察组,每组各60例,对照组在苏醒期时给予常规护理,观察组在对照组的护理基础上给予保温护理,比较2组患者术中不同时间段体温、应激反应指标及术后复苏情况.结果 手术开始30、60 min及手术结束时,观察组体温分别为(36.39 ± 0.34)、(36.50 ± 0.38)、(36.56 ± 0.38)℃,对照组分别为(35.49 ± 0.31)、(35.63 ± 0.41)、(36.17 ± 0.52)℃,2组比较差异有统计学意义(t=15.15、12.01、4.69,P＜0.05).手术开始30、60 min及手术结束时观察组去甲肾上腺素(NE)分别为(279.3 ± 87.4)、(321.5 ± 110.6)、(363.5 ± 108.2)ng/L,肾上腺素(E)分别为(342.5 ± 81.6)、(320.2 ± 59.4)、(169.4 ± 54.2)ng/L;对照组NE分别为(244.8 ± 87.5)、(390.8 ± 98.6)、(469.7 ± 97.7)ng/L,E分别为(129.5 ± 39.6)、(187.0 ± 51.3)、(327.6 ± 68.9)ng/L, 2组比较差异有统计学意义(t=2.161～18.190,P＜0.05);观察组手术时间、术后PACU滞留时间、意识完全恢复以及拔除气管导管时间分别为(65.93 ± 21.94)、(32.85 ± 3.22)、(18.60 ± 5.26)、(24.19 ± 6.73)min,对照组分别为(87.52 ± 18.42)、(50.06 ± 4.27)、(26.54 ± 4.81)、(32.40 ± 8.05)min,2组比较差异有统计学意义(t=5.838～24.927,P＜0.05).结论 全麻苏醒期保温护理可有效改善全麻胸腔镜肺手术患者苏醒质量,降低手术应激状况,值得在临床推广.

abstractsObjective To discuss the influence of temperature-holding nursing in the anesthesia and stress state during the recovery period of general anesthesia for patients with thoracoscopic lung surgery. Methods 120 patients with thoracoscopic lung surgery underwent the general anesthesia from January 2017 to July 2018 in our hospital were selected and randomly assigned to two groups, 60 cases in each group. At the recovery period, the control group was treated with conventional nursing; the observation group was treated with conventional nursing and temperature-holding nursing. At each time period, the body temperature, stress response and postoperative rehabilitation conditions were probed. Results At the end of the operation 30 minutes, 60 minutes and the end of the operation, the body temperature of the observation group was (36.39 ± 0.34)°C, (36.50 ± 0.38)°C, (36.56 ± 0.38)°C, and the control group was (35.49 ± 0.31)°C, (35.63 ± 0.41) °C, (36.17 ± 0.52)°C, the difference between the two groups was statistically significant (t=15.15, 12.01, 4.69, P<0.05). NE was (279.3 ± 87.4)ng/L, (321.5 ± 110.6)ng/L, (363.5±108.2) ng/L at 30 min, 60 min, and end of surgery. E was (342.5±81.6)ng/L, (320.2± 59.4)ng/L, (169.4±54.2)ng/L at 30 min, 60 min, and end of surgery. NE in the control group were (244.8± 87.5)ng/L, (390.8±98.6)ng/L, (469.7±97.7)ng/L, and E was (129.5±39.6)ng/, (187.0±51.3) ng/L, (327.6 ± 68.9) ng/L, and he difference between the two groups was statistically significant (t=2.161~13.979, P<0.05).The operation time, the postoperative retention time of PACU, the complete recovery of consciousness and the time of removal of tracheal catheter in the observation group were (65.93±21.94) min, (32.85±3.22) min, (18.60±5.26) min, (24.19±6.73) min, respectively. The groups were (87.52±18.42) min, (50.06 ± 4.27) min, (26.54 ± 4.81) min, (32.40 ± 8.05) min, and the difference between the two groups was statistically significant (t=5.838~24.927, P<0.05). Conclusion The temperature-holding nursing can improve the recovery conditions and reduce the stress response for patients with thoracoscopic lung surgery. It is worthy of clinical promotion.