综合保温措施在肝癌手术患者快速康复外科中的应用*

doi:10.3969/j.issn.1672-5069.2014.04.013

实用肝脏病杂志 ›› 2014, Vol. 17 ›› Issue (4): 384-388.doi: 10.3969/j.issn.1672-5069.2014.04.013

综合保温措施在肝癌手术患者快速康复外科中的应用^*

陈荣珠, 王桂红, 荚卫东, 宇静, 杜李兵

230001 合肥市安徽医科大学附属省立医院手术室（陈荣珠,王桂红,宇静,杜李兵）; 肝脏外科（荚卫东）

收稿日期:2014-01-20 出版日期:2014-08-30 发布日期:2016-04-11
通讯作者: 荚卫东,E-mail:jwd1968@sina.com
作者简介:陈荣珠,女,42 岁,大学本科,主管护师,护士长。主要从事手术室临床和管理工作。E-mail:rzchen508@139.com
基金资助:
安徽省科技攻关资助项目（编号：1301042199）

Application of comprehensive insulation measures under fast-track surgery in patients with hepatocellular carcinoma

Chen Rongzhu, Wang Guihong, Jia Weidong

Emergency Center Operation Room,Anhui Provincial Hospital,Hefei 230001,Anhui Province,China

Received:2014-01-20 Online:2014-08-30 Published:2016-04-11

摘要/Abstract

摘要： 目的观察综合保温措施对肝癌肝切除患者术中体温变化及术后恢复期的影响。方法将60例行肝切除治疗的原发性肝癌患者随机分为对照组30例,采取常规保温措施;和观察组30例,采取综合保温措施。观察两组患者术中体温变化、苏醒期寒战、躁动发生情况、术后咳嗽、发热发生率及首次下床活动时间、平均住院天数。结果观察组在肝实质离断后和苏醒期体温分别为（36.0±0.43）℃和（36.1±0.37）℃,对照组分别为（35.7±0.33）℃和（35.8±0.20）℃,观察组术中低体温发生率低于对照组（P<0.01）;观察组苏醒期寒战和躁动的发生率分别为10.0%和13.3%,对照组分别为40.0%和36.7%,观察组术后咳嗽和发热的发生率分别为13.3%和10.0%,对照组分别为36.7%和33.3%,两组比较差异有显著的统计学意义（P<0.05）;观察组术后首次下床活动时间为（26.8±3.6） h,对照组是（41.2±4.4） h,观察组术后平均住院（8.1±1.8） d,对照组是（10.2±1.6）d,两组比较差异有显著意义（P<0.05）。结论综合保温措施能有效维持肝癌患者术中正常体温,减少苏醒期寒战、躁动及术后并发症的发生,在肝癌患者快速康复外科治疗中发挥了积极的作用。

关键词: 肝癌, 综合保温, 快速康复外科

Abstract: Objective To observe the effects of comprehensive insulation measures on changes of temperature in patients with hepatocellular carcinoma（HCC） underwent hepatectomy and on postoperative recovery. Methods Sixty patients with HCC were randomly divided into control and observation group. 30 cases in control group were given regular insulation measures,while the other 30 cases in observation were treated with comprehensive insulation measures when they underwent hepatectomy. The temperature variation,emergence agitation and shiver,the incidence of postoperative complications such as cough and fever,the leaving bed time and average hospitalization days were compared between the two groups. Results The temperatures of patients in observation group after liver parenchyma transaction and during recovery period were（36.0±0.43）℃ and （36.1±0.37）℃,respectively,while they were（35.7±0.33）℃ and（35.8±0.20）℃ in control group,and the incidence of hypothermia during operation in observation group was significantly lower than that in the control group（P<0.01）. The incidences of shiver and emergence agitation during recovery period were 10.0% and 13.3%,respectively in observation group,while they were 40.0% and 36.7%,respectively in control group. Incidence of postoperative cough and fever were 13.3% and 10.0%, respectively in observation group, while they were 36.7% and 33.3%,respectively in control group （P<0.05）.The first leaving bed time was（26.8±3.57）hours in observation group,while it was （41.2±4.44）hours in control group（P<0.05）. The mean hospital stay was（8.1±1.79）d in observation group,while it was （10.2±1.59）d in control group（P<0.05）. ConclusionsComprehensive insulation measures can effectively maintain relatively normal body temperature in patients with HCC during hepatectomy. It can also reduce the incidence of emergence agitation and shiver,as well as the occurrence of postoperative complications. Furthermore, comprehensive insulation measures play an active role in fast-track surgery （FTS） of patients with HCC.

Key words: Hepatocellular carcinoma, Comprehensive insulation measures, Fast-track surgery

陈荣珠, 王桂红, 荚卫东, 宇静, 杜李兵. 综合保温措施在肝癌手术患者快速康复外科中的应用^*[J]. 实用肝脏病杂志, 2014, 17(4): 384-388.

Chen Rongzhu, Wang Guihong, Jia Weidong. Application of comprehensive insulation measures under fast-track surgery in patients with hepatocellular carcinoma[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(4): 384-388.

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综合保温措施在肝癌手术患者快速康复外科中的应用^*

Application of comprehensive insulation measures under fast-track surgery in patients with hepatocellular carcinoma

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